The recent increase in mental health problems probably reflects the fragmentation of social cohesion of modern society, with changes in family composition, work and living habits, peer communication and virtual-based reality. Fragmentation can also be due to the rapid expansion of urban agglomerations, too often chaotic and unregulated, the increase of market illicit substances, the reduction of social networks and the increase of social distance among people. As society changes, psychiatry has to adapt its role and target, moving from the treatment of mental disorders to the management of mental health problems.
This adaptation will require a re-examination of the paradigms of psychiatry on which mental healthcare professionals have based their practice over the last century. Re-examination should include the paradigm of mental disorders as nosological entities with the development of a new psychiatric nosology, the concept of single disease entity, and a patient-centered psychopathology, since actual descriptions are not able to catch the inner world and reality of patients with mental health problems. Some of these changes will be highlighted and discussed in this paper.