background The constructivist position is often used for psychiatric diseases, in contrast with the general medical view. In the medical view a biological substrate is decisive for a classification as ‘disease’, which is not the case in the constructivist position.
aim We investigate how both positions relate to each other in psychiatric diseases.
method Analysis based on a conceptual analysis of Ian Hacking’s book The Social Construction of What? (1999).
results Different objects ought to be distinguished in a constructivist analysis of psychiatric diseases; the disease itself and the idea or concept of that disease. These different objects interact with each other. These interactions can be made explicit by distinguishing interactive kinds from indifferent kinds. Doing so makes it clear that even if a disease is not determined by a biological substrate, this does not imply that a biological substrate is something completely separate from that disease.
conclusion Hacking’s philosophy makes it possible to move beyond the opposition between the medical and the constructivist account of psychiatric diseases by combining both accounts.