title: The six most essential questions in psychiatric diagnosis: a pluralogue. Part 4: general conclusion.
abstract: In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis - the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances' responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first - what is the nature of psychiatric illness - and that in some manner all further questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders - and future nosologies - as far more complex and uncertain than we have imagined.
authors.affiliation: Department of Psychiatry, Yale School of Medicine, 300 George St, Suite 901, New Haven, CT 06511, USA. james.phillips@yale.edu
authors.forename: James
authors.initials: J
authors.lastname: Phillips
authors.forename: Allen
authors.initials: A
authors.lastname: Frances
authors.forename: Michael A
authors.initials: MA
authors.lastname: Cerullo
authors.forename: John
authors.initials: J
authors.lastname: Chardavoyne
authors.forename: Hannah S
authors.initials: HS
authors.lastname: Decker
authors.forename: Michael B
authors.initials: MB
authors.lastname: First
authors.forename: Nassir
authors.initials: N
authors.lastname: Ghaemi
authors.forename: Gary
authors.initials: G
authors.lastname: Greenberg
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Hinderliter
authors.forename: Warren A
authors.initials: WA
authors.lastname: Kinghorn
authors.forename: Steven G
authors.initials: SG
authors.lastname: LoBello
authors.forename: Elliott B
authors.initials: EB
authors.lastname: Martin
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Mishara
authors.forename: Joel
authors.initials: J
authors.lastname: Paris
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Pierre
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Pies
authors.forename: Harold A
authors.initials: HA
authors.lastname: Pincus
authors.forename: Douglas
authors.initials: D
authors.lastname: Porter
authors.forename: Claire
authors.initials: C
authors.lastname: Pouncey
authors.forename: Michael A
authors.initials: MA
authors.lastname: Schwartz
authors.forename: Thomas
authors.initials: T
authors.lastname: Szasz
authors.forename: Jerome C
authors.initials: JC
authors.lastname: Wakefield
authors.forename: G Scott
authors.initials: GS
authors.lastname: Waterman
authors.forename: Owen
authors.initials: O
authors.lastname: Whooley
authors.forename: Peter
authors.initials: P
authors.lastname: Zachar
mesh_terms: D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D001523:Mental Disorders / Q000145:classification / Q000175:diagnosis*; D015203:Reproducibility of Results; D009626:Terminology as Topic