Современная мировая психиатрия Mario Maj Department of Psychiatry, Universaty of Naples SUN, Naples, Italy From «madness» to «mental health problems»: refl ections on the evolving target of psychiatry There was a time when target of psychiatric profession was very clear and widely accepted. <...> It was «madness», that is a few patterns of behavior and experience which were obviously beyond the range of normality. <...> In the perception of part of the public opinion, several colleagues of other medical disciplines and paradoxically of some fervent critics of old asylums, its traditional target have remained unchanged: psychiatry deals with people who are «mad». <...> It has become a range of mental disorders (or of «mental health problems», according to some offi - cial documents of international organizations), including several conditions which are obviously on a continuum with a normality. <...> This boundary is often determined on pragmatic grounds or on the basis of «clinical utility» (i.e., prediction of clinical outcome and response to treatment), although this pragmatism may involve some tautology (in fact, requiring a diagnostic threshold to be predictive to response of treatment seems to imply that a condition becomes a mental disorder when there is an eff ective treatment available for it). <...> On the one hand, the professions is being accused to unduly pathologize ordinary life diffi culties in order to expand its infl uence [e.g., 1, 2]. <...> This criticism becomes harsher when the abovementioned evolution of the psychiatric target from «madness» to «mental health problems» is, in good or bad faith, ignored: pathologizing ordinary life diffi culties become «making us crazy» [3]. <...> Within this frame, especially in those countries in which social mental health services are most developed and psychiatrists are leading those services, there is a call for dealing with «mental health problems» which are not proper mental disorders, such as the serious psychological distress occurring as a consequence of a natural disaster or of the ongoing economic crisis. <...> Indeed, the ongoing economic crisis has a signifi cant impact on the mental health of the population in many countries, especially where a scarce social protection is available for people who become unemployed, indebted or poor due to the crisis <...>