Implicações do estado de risco para psicose na saúde da família: dos critérios psiquiátricos à clínica psicanalítica

Abstract

In the health field, there is a discussion about the risks of the emergence of health problems, as well as their management in disease prevention. In the midst of this debate, mental health has also been examining the notion of risk for suffering and mental disorders. Our work, through a literature review, investigates the implications of the notions of risk for psychosis in the field of family health. In this regard, we use psychoanalysis to provide a critical counterpoint to the psychiatric concept of risk status for psychosis. We have covered the historical changes that the concept of psychosis has undergone over the centuries, as well as its encounter with risk prevention medicine. It was also scanned how the diagnostic construction of contemporary psychiatry occurs through the classification manuals and attempt of DSM to draw diagnostic criteria that define what is attenuated psychosis syndrome. Psychosis, as a structural diagnosis, had its concept revised again, with emphasis on the state of pre-psychosis, for understanding the psychoanalytic clinic. Finally, our work allowed us to discuss the possible political and clinical impacts of operationalization by risk state mental criteria. We argue that the current scenario of unpreparedness in the conduct of mental health in family health, also taking into account the enormous interference of pharmaceutical capital in medical-psychiatric science, could result in an explosion of new patients who, while not being ill, on the other they keep a state of unhealthy – so-called at-risk patients. We conclude by reaffirming the need to build a one-on-one clinic that values singularity over statisticians.