Skip to main content

Advertisement

Log in

Psychopathology and classification in psychiatry

  • Invited Reviews
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Introduction

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.

Commentary

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.

Conclusion

Two broadly similar solutions are proposed for an alternative approach to common mental disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM-5), 5th edn. American Psychiatric Association, Arlington, VA, p 946

  2. Greenberg G (2013) The rats of N.I.M.H. The New Yorker, 16 May 2013

  3. Coghlan A, Reardon S (2013) Psychiatry divided as mental health ‘bible’ denounced. New Scientist, 3 May 2013

  4. Horgan J (2013) Psychiatry in crisis! Mental health director rejects psychiatric “Bible” and replaces with… Nothing. Scientific American, 4 May 2013

  5. The International Classification of Disease (ICD) (1992) The ICD-10 classification of mental and behavioural disorders. Diagnostic criteria for research. World Health Organisation, Geneva

    Google Scholar 

  6. Feinstein AR (1970) The pre-therapeutic classification of comorbidity in chronic disease. J Chronic Dis 23:455–468

    Article  Google Scholar 

  7. Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, Kendler K (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry 51:8–19

    Article  CAS  PubMed  Google Scholar 

  8. Vollebergh WA, Iedema J, Bijl RV, de Graa R, Smit F, Ormel J (2001) The structure and stability of common mental disorders. The Nemesis Study. Arch Gen Psychiatry 58:597–603

    Article  CAS  PubMed  Google Scholar 

  9. Slade T, Watson D (2006) The structure of common DSM-IV and ICD-10 mental disorders in the Australian general population. Psychol Med 36:1593–1600

    Article  PubMed  Google Scholar 

  10. The International Classification of Disease (ICD) (1992) The ICD-10 classification of mental and behavioural disorders. Clinical descriptions and diagnostic guidelines. World Health Organisation, Geneva

    Google Scholar 

  11. World Health Organisation (1996) ICD-10 diagnostic and management guidelines for mental disorders in primary care. Primary care version. World Health Organisation/Hogrefe & Huber, Gottingen

  12. Simms LJ, Prisciandaro JJ, Krueger RF, Goldberg DP (2012) The structure of depression, anxiety and somatic symptoms in primary care. Psychol Med 42:15–28

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Goldberg DP, Simms LJ, Gater R, Krueger RF (2011) Integration of dimensional spectra for depression and anxiety into categorical diagnoses for general medical practice. In: Regier D, Narrow WE, Kuhl EA, Kupfer DJ (eds) The conceptual evolution of DSM-5. American Psychiatric Publishing, Washington, DC, pp 19–36

    Google Scholar 

  14. Goldberg DP, Bridges K, Duncan-Jones P, Grayson D (1987) Dimensions of neuroses seen in primary care settings. Psychol Med 17:461–470

    Article  CAS  PubMed  Google Scholar 

  15. Goldberg DP, Prisciandaro JJ, Williams P (2012) The detection of common mental disorders in general medical settings. Gen Hosp Psychiatry 34(6):665–670

  16. Goldberg DP (2012) The overlap between the common mental disorders—challenges for classification. Int Rev Psychiatry (Early Online: 1–7)

  17. Goldberg D, Klinkman M (2013) Primary health care and the ICD-11. Die Psychiatrie 10(1):33–37

  18. Insel T, Cuthbert BN, Garvey M (2010) Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry 167:748–751

    Article  PubMed  Google Scholar 

  19. Cuthbert BN (2014) The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology. World Psychiatry 13:28–35

    Article  PubMed Central  PubMed  Google Scholar 

Download references

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.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David Goldberg.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Goldberg, D. Psychopathology and classification in psychiatry. Soc Psychiatry Psychiatr Epidemiol 50, 1–5 (2015). https://doi.org/10.1007/s00127-014-0924-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-014-0924-y

Keywords

Navigation