TY - JOUR
T1 - The six most essential questions in psychiatric diagnosis
T2 - A pluralogue part 1: Conceptual and definitional issues in psychiatric diagnosis
AU - Phillips, James
AU - Frances, Allen
AU - Cerullo, Michael A.
AU - Chardavoyne, John
AU - Decker, Hannah S.
AU - First, Michael B.
AU - Ghaemi, Nassir
AU - Greenberg, Gary
AU - Hinderliter, Andrew C.
AU - Kinghorn, Warren A.
AU - LoBello, Steven G.
AU - Martin, Elliott B.
AU - Mishara, Aaron L.
AU - Paris, Joel
AU - Pierre, Joseph M.
AU - Pies, Ronald W.
AU - Pincus, Harold A.
AU - Porter, Douglas
AU - Pouncey, Claire
AU - Schwartz, Michael A.
AU - Szasz, Thomas
AU - Wakefield, Jerome C.
AU - Waterman, G. Scott
AU - Whooley, Owen
AU - Zachar, Peter
N1 - Funding Information:
MF is an external consultant to the NIMH Research Domain Criteria (RDoC) Project. NG has research grants from Pfizer and Sunovion, and is a research consultant for Sunovion. MS is a consultant for AstraZeneca, Merck, Novartis and Sunovion. Other authors report no competing interests.
PY - 2012/1/13
Y1 - 2012/1/13
N2 - In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.
AB - In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.
UR - http://www.scopus.com/inward/record.url?scp=84855723436&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84855723436&partnerID=8YFLogxK
U2 - 10.1186/1747-5341-7-3
DO - 10.1186/1747-5341-7-3
M3 - Review article
C2 - 22243994
AN - SCOPUS:84855723436
SN - 1747-5341
VL - 7
JO - Philosophy, Ethics, and Humanities in Medicine
JF - Philosophy, Ethics, and Humanities in Medicine
IS - 1
M1 - 3
ER -