In the nineteenth century medicine changed in many ways, including a shift in thinking about disease. Instead of seeing disease as the identification of symptoms, it was the linkage of symptoms to distinct pathologies, understood as departures from normal function, that came to define disease.
Genuine mental illnesses, are not just sets of co-occurring symptoms but destructive processes taking place in biological systems.
This may be termed the strong interpretation of the medical model.
In contrast, a minimal interpretation of the medical model thinks of mental disorders as collections of symptoms that occur together and unfold in characteristic ways, but it makes no commitments about the underlying causes of mental illness
One side the Minimalists treat diagnostic labels as useful heuristics (Heuristics are a problem-solving method that uses shortcuts to produce good-enough solutions) rather than natural kind terms,
whereas a strong interpretation commits psychiatry to a view of mental illness as a medical disease in the strongest sense, that of a pathogenic process unfolding in bodily systems.
Andreasen (2001, 172–76) embraces the strong interpretation. She argues that psychiatry, now emerging as a form of cognitive neuroscience, is for the first time able to identify the specific pathophysiologies that underpin the symptoms of mental illness.
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