The strengths and weaknesses of the 5th edition of the Diagnostic and Statistical Manual of the American Psychiatric Association are considered, and the likely form of the revised version of the International Classification of Disease, due to be released in the future is briefly considered.
It is argued that there are a number of problems in the checklist approach to diagnosis: there are no points of rarity between common disorders, and that many disorders are rough groupings containing highly heterogeneous syndromes. The tendency to reify these disorders and to view them as independent entities, and to stretch the concept of co-morbidity to cover individuals who satisfy more than one of the diagnostic checklists is seen as being misleading as it gives a false air of precision.
Two broadly similar solutions are proposed for an alternative approach to common mental disorders.
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Conflict of interest
The author states he has no conflict of interest other than being Chairman of the Primary Care Consultation Group of WHO for the design of ICD11-PHC.
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Goldberg, D. Psychopathology and classification in psychiatry. Soc Psychiatry Psychiatr Epidemiol 50, 1–5 (2015). https://doi.org/10.1007/s00127-014-0924-y
- Categorical models