Diagnostic Criteria for ‘Mental Disorders’: Treatment, Therapy and Basic Science
The notion of a ‘mental disorder’ rests upon a particular model of so-called ‘normal’ functioning and observable deviations from that norm; this model fits only awkwardly with some approaches to therapy. Perhaps even more significantly, unlike the usual notion of ‘diagnosis’ common to Western medicine, however, psychiatry’s diagnostic categories of mental disorders are defined in terms of lists of symptoms. Scientifically, they are nothing at all like most medical diagnoses.
Therapy, ‘Treatment’ and the Role of Clinical Diagnostic Criteria
In my own face-to-face and online therapy practice, I do not treat clients as manifestations of one or more mental illnesses or mental disorders in need of medical fixing. No one is merely a case of bipolar disorder or bulimia nervosa, an obsessive-compulsive, or a paranoid schizophrenic. In my view, formal diagnostic categories do hold some value in terms of contextual information, but they play a much less important role than the specific personal circumstances of a given client. If you are a client, you are — first and foremost — a specific, unique individual. Bringing along any particular diagnostic label does not tell me nearly as much about you and your experience as you can. It certainly does not tell me what you ‘need’ as ‘treatment’.
Nonetheless, in my experience of working with clients who have received formal psychiatric diagnoses from other mental health professionals, I have often found that clients feel they lack adequate information about what these diagnostic labels actually mean — and that was my original reason for bringing together the collection of information available in this section. The entries in this guide to ‘mental disorders’ and symptoms aim to provide the basic facts about each of several diagnostic labels. Please note that the diagnostic information provided here is for educational purposes only and cannot replace the advice of a qualified mental health professional.
More information about the source of such diagnostic labels is available on the page on the DSM and ICD; a complete list of DSM diagnostic codes is also available.
Are Psychiatric Diagnoses Really Medical Diagnoses?
Under the medical model common to most Western countries, the notion of diagnosis refers to the identification of the nature and cause of a disease, injury or other deviation from normal functioning. Typically, direct physical measurements are undertaken to narrow down the set of possible causes (the differential diagnosis) which could explain the symptoms that have been observed by the physician or reported by the patient. Crucially, this means that a medical diagnosis is not merely a collection of symptoms; a medical diagnosis adds new information to the clinical picture which is not available merely from collecting together any given set of symptoms. It adds new information about causation, treatment, prognosis, complications, and more.
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In the case of ‘diagnosing’ mental disorders, however, the ‘diagnoses’ are actually defined in terms of the presence or absence of a given set of symptoms. Unlike the case of diabetes, for example, there is no simple blood test for depression or anorexia nervosa or any other mental disorder. By definition, to be depressed is not to have some particular bodily feature; by definition, to be depressed is to have one’s experience accurately characterized by a particular set of symptom descriptions. (Likewise, screening tests for depression or other mental disorders are merely tallying up sets of symptoms.) So a ‘diagnosis’ of bipolar disorder, for example, does not tell us anything new, over and above the presence of particular symptoms defined in a list. By contrast, a diagnosis of diabetes or hyperthyroidism tells us a great deal more than the set of symptoms which might be experienced by diabetics or those with overactive thyroid glands. The bottom line is that psychiatric diagnoses are explanatorily empty, and it is for this reason that they are correctly placed in a very different area of the scientific landscape than ‘real’ (Western medical) diagnoses. They might help clients (and therapists) to understand context, and they might offer statistically relevant indications of potentially useful drug treatments, but they are nothing like the standard diagnoses of Western medicine.
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All clinical material on this site is peer reviewed by one or more clinical psychologists or other qualified mental health professionals. This specific article was originally published by Dr Greg Mulhauser, Managing Editor on .on and was last reviewed or updated by