查看文章

Discussions about alternatives to psychiatric diagnosis inevitably arouse controversy. But it is difficult to see how things can continue as they are, in view of the seemingly intractable problems facing diagnostic systems. These problems, which have been extensively discussed in relation to the Diagnostic and Statistical Manual of Mental Disorders 5, include the continuing and acknowledged1 failure to find biomarkers, which might validate categories; extensive overlap across categories and variation of symptoms within them; 2–4 and the absence of treatment specificity5 so that, for example, neuroleptics have been recommended for schizophrenia, depression, anxiety, bipolar disorder, personality disorder, and attention deficit hyperactivity disorder. 6 Perhaps most worryingly, although some service users experience diagnosis as a relief, a substantial number of other users testify that it conveys messages of deficit …