The disease entity in psychiatry: fact or fiction?
BACKGROUND
The current debate concerning the forthcoming revisions of the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) lacks sufficient historical perspective on groundwork concepts in psychiatry, such as the nature of the disease entity, categorical typologies, dimensional models and their validity and utility.


OBJECTIVE
To offer an overview of the evolution and metamorphoses of the conceptual basis of classification in psychiatry, with particular focus on psychotic disorders.


METHODS
Discursive, proceeding from history of ideas to a critique of present dilemmas.


RESULTS
Much of the present-day discussion of basic issues concerning the classification of mental disorders is a replay of debates that took place in the earlier periods of scientific psychiatry. CONCLUSION; The mainstream nosological paradigm adopted in psychiatry since early 20th century is in need to be critically examined and transcended with the help of concepts and methodological tools available today.
The University of Western Australia, Perth, Australia. assen.jablensky@uwa.edu.au
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Jablensky
D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D038801:International Classification of Diseases; D001523:Mental Disorders / Q000145:classification* / Q000175:diagnosis; D011569:Psychiatric Status Rating Scales / Q000592:standards; D011570:Psychiatry / Q000379:methods*; D015203:Reproducibility of Results; D009626:Terminology as Topic