Criticism of psychiatric diagnosis

Abstract

Criticisms of psychiatric diagnostic constructs from a clinical/scientific view have been made on several points: reliability, such as how often two clinicians agree on the same diagnosis; validity, such as clear separation between diagnostic constructs or presence of objective validators; utility, such as predicting outcomes and treatment responses; implying an inaccurate conception of mental health problems as diseases that also minimizes the influence of social causative factors, high rates of co-occurrence, and association with negative consequences such as stigma. Many psychiatric diagnostic constructs lack validity but often have clinical utility. This clinical utility depends on how the clinician works therefore psychiatric diagnostic constructs are well suited to the medical model but may have little utility for other mental health professionals who work differently or for researchers testing hypotheses. Diagnostic constructs have utility for administrative purposes. The criticisms can be used to generate a set of questions to evaluate psychiatric diagnostic constructs. Psychiatric diagnostic constructs are best compared with general medical diagnostic constructs because they are used for similar purposes in clinical decision-making. A comparison will be made to see if there is no overlap, some overlap, or near total overlap between general medical and psychiatric diagnostic constructs.