Welcome to the 22nd WCP Congress Program Scheduling

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The WPA Psychiatry for the Person Institutional Program and the ICPCM Person Centered Medicine programmatic movement sponsored the development of the Person-centered Integrative Diagnosis (PID) model [1]. It involved three informational domains, i.e., Health Status (from illnesses to well-being), Risk and Protective Factors, and Health Experience and Values, collaboratively evaluated by clinicians, patient and family; and described with categories, dimensions and narratives.

The Latin American Psychiatric Association applied the PID model into a Latin American Guide for Psychiatric Diagnosis (GLADP)[2]. Its evaluation among Latin American psychiatrists comparing it against the original ICD-10, DSM-IV and DSM-5 systems found the GLADP preferred to the listed standard systems reportedly because it is person-centered and culturally-informed [3].

A critical review of the literature towards optimizing person-centered diagnosis identified promising developments such as enhancing the contextualization of the health condition both cross-sectionally (considering eco-bio-psycho-socio-spiritual dimensions and determinants of health and personhood) and longitudinally (from the person’s history to his/her life project) and the co-production by patient, clinicians and family of a collaborative narrative diagnostic summary potentiated hermeneutically to serve as basis for launching a collaborative care decision process [4].

References
1. Mezzich, J. E., Salloum, I. M., Cloninger, C. R., Salvador-Carulla, L., Kirmayer, L., Banzato, C. E., Wall-craft, J., & Botbol, M. (2010). Person-centered Integrative Diagnosis: Conceptual Bases and Structural Model. Canadian Journal of Psychiatry, 55, 701-708.
2.Asociación Psiquiátrica de América Latina, Sección de Diagnóstico y Clasificación. (2012). Guía Latinoamericana de Diagnóstico Psiquiátrico, Version revisada (GLADP-VR). Asociación Psiquiátrica de América Latina, Lima.
3.Saavedra JE, Otero A, Brítez J, Velásquez E, Salloum IM, Zevallos S, Luna Y, Paz V, Mezzich JE (2017): Evaluation of the Applicability and Usefulness of the Latin American Guide for Psychiatric Diagnosis, Revised Version, in Comparison with Other International Systems among Latin American Psychiatrists. International Journal of Person Centered Medicine, 7: 216-224.
4.Mezzich JE, Salloum IM, Wong MTH, Braš M, Đorđević V, Wilson CR (in press): Person-centered Interviewing and Diagnosis. In: Mezzich JE, Appleyard WJ, Glare P, Snaedal J, Wilson CR (.eds): Person Centered Diagnosis. Springer Nature Switzerland.

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Person Centered Medicine affirms the whole person of the PATIENT IN CONTEXT as the center of clinical care and health promotion at the individual and community levels. It upholds science as the essential cornerstone of medicine and humanism as its essence. Core principles of Person-centered Medicine include ethical commitment, cultural awareness and responsiveness, holistic framework and treatment, relational focus, individualization of care, common ground for collaborative diagnosis and shared decision making, people centered organization of care and person-centered education, training, and research.
The Person-centered Integrative Diagnosis (PID) is an emerging model for conceptualizing the process of clinical diagnosis and care, implementing the vision of person-centered medicine. The PID is a culturally informed multilevel model that allow assessment of ill-health and positive aspects of health through the following three levels: Health Status (includes illness & disabilities, wellbeing & adaptive functioning), Contributory to the health status (including internal and external risk and protective factors, including eco-Bio-Psycho-Socio-Spiritual Dynamics), and Experience of the Health Status (cultural factors and values concerning ill health and positive aspects of health). The PID attempts to capture a personalized view of mental health and ill health conceptualized as contextualized and complex dynamic processes specific to each individual. Integrating science-based underlying neurobiological mechanisms of mental illness is an important aspect for optimizing the clinical utility of the PID. This presentation will discuss integrating neurobiological findings in alcoholism and other addictive disorders within the PID as an essential component of the complex dynamic interactive system considering the eco-Bio-Psycho-Socio-Spiritual dynamics.


References:
Kwako LE, Momenan R, Litten RZ, Koob GF, Goldman D. Addictions Neuroclinical Assessment: A Neuroscience-Based Framework for Addictive Disorders. Biol Psychiatry. 2016 Aug 1;80(3):179-89.
Khantzian E.J. (2015) Psychodynamic Psychotherapy for the Treatment of Substance Use Disorders. In: el-Guebaly N., Carrà G., Galanter M. (eds) Textbook of Addiction Treatment: International Perspectives. Springer, Milano. https://doi.org/10.1007/978-88-470-5322-9_38
Salloum IM, Mezzich JE. Outlining the bases of person‐centered integrative diagnosis. Journal of Evaluation in Clinical Practice. 2011;17(2):354-356.

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Personalized and precision medicine and psychiatry aim to tailor diagnostic assessment and interventions to more detailed characterization of individuals in terms of biological measures derived from various forms of ‘omics’ (e.g. genomics, proteomics, metabolomics) Current efforts to expand the framework to include personal or social dimensions are limited and generally involve lists of factors that are deemed relevant because they influence previously identified sub-personal biological processes or social-environmental determinants of health identified through epidemiological studies. Missing from this is the person as embodied locus of agency and subjectivity and all that entails (i.e., phenomenology, narrativity, historicity, ethical and aesthetic value, etc.). Current approaches in precision medicine also do not adequately engage with the social and cultural contexts of human development and experience. This presentation will illustrate how a multilevel ecosocial view of the person, cognition and experience can be translated into a practical assessment framework and applied to advance a truly person-centered psychiatry.

References
Kirmayer (2015). Re-visioning psychiatry: Toward an ecology of mind in health and illness. In: Kirmayer, L. J., Lemelson, R., & Cummings, C. A. (Eds.). (2015). Re-visioning psychiatry: Cultural phenomenology, critical neuroscience, and global mental health (pp. 622-660). Cambridge University Press.
Kirmayer, L. J. (2016). The future of cultural formulation. In: Lewis-Fernandez et al. (Eds.) DSM-5 Handbook on the Cultural Formulation Interview (pp. 267-285). APPI Press.
Kirmayer, L. J. (2019). Toward an ecosocial psychiatry. World Social Psychiatry, 1(1), 30.
Kirmayer, L.J. & Gomez-Carrillo, A. (2019). Culturally responsive clinical psychology and psychiatry: An ecosocial approach. In: Maercker, A., Heim, E. & Kirmayer, L.J. (Eds.) Cultural Clinical Psychology and PTSD (pp. 3-21). Boston: Hogrefe.