DSM-5 and the Forthcoming Chaos Over Diagnosis in Psychiatry: Time for a Bold New Initiative?

With the recent publication of the American Psychiatric Association’s DSM-5, and all the controversy now swirling around this document, there is likely to be a period of some years of chaos around diagnosis in psychiatry. The “power vacuum” so created can be seen as providing a unique opportunity to undertake fundamental rethinking of the significance of psychiatric diagnosis, as well as the details of any future scheme. In fact, such rethinking will need to go far beyond the “nuts and bolts” – the details – of specific diagnoses: What has been missing in the past has been a secure understanding of what is needed at a philosophical level, in order to devise a workable system of diagnosis in psychiatry (if diagnosis is still to be retained as the correct concept) – a system based on scientific rationality rather than on consensus and convention. This essay explores the philosophical underpinnings of such a fundamental rethink of diagnosis in psychiatry, and makes suggestions for the underlying framework for far-reaching revision. [Posted 23.09.2013]
Revision of diagnostic system