Diagnostic manuals of mental disorders, such as the latest version of the DSM, have been developed to provide clinicians with a unified diagnostic matrix by grouping the various symptoms of mental ill health into discrete entities.
By performing a detailed analysis of schizophrenia, bipolar disorder, depressive disorders, anxiety disorders and trauma-related disorders – all entities listed in the DSM-5 – researchers from the University of Liverpool have found all of them to be “scientifically meaningless”.
“Although diagnostic labels create the illusion of an explanation they are scientifically meaningless and can create stigma and prejudice. I hope these findings will encourage mental health professionals to think beyond diagnoses and consider other explanations of mental distress, such as trauma and other adverse life experiences,” said lead researcher Dr Kate Allsopp.
The psychiatric categories used by most experts in the field of psychiatry today have been found to be based on divergent decision-making rules, significantly overlap in terms of symptoms, mask the role of trauma and other adverse life events, and provide very little information on patients’ circumstances and the types of treatment they might respond to.
Psychiatric diagnoses were found to hinge on inconsistent criteria, such as comparing a symptom to a poorly defined state of normality or the person’s previous experiences, setting arbitrary thresholds and durations, etc.
“This study provides yet more evidence that the biomedical diagnostic approach in psychiatry is not fit for purpose. Diagnoses frequently and uncritically reported as ‘real illnesses’ are in fact made on the basis of internally inconsistent, confused and contradictory patterns of largely arbitrary criteria. The diagnostic system wrongly assumes that all distress results from disorder, and relies heavily on subjective judgments about what is normal,” explained co-author Peter Kinderman.
In conclusion, the authors suggest a move away from “medical-sounding” labels which have little basis in actual symptomatology or underlying biochemistry, and focus more on the “complex causes of human distress” on a case-by-case basis.
The study was published in the journal Psychiatry Research.