Study finds psychiatric diagnosis to be ‘scientifically meaningless’

Summary: Researchers conclude many psychiatric diagnoses are scientifically worthless as tools for identifying discrete mental health disorders.

Source: University of Liverpool

A new study, published in Psychiatry Research, has concluded that psychiatric diagnoses are scientifically worthless as tools to identify discrete mental health disorders.

The study, led by researchers from the University of Liverpool, involved a detailed analysis of five key chapters of the latest edition of the widely used Diagnostic and Statistical Manual (DSM), on ‘schizophrenia’, ‘bipolar disorder’, ‘depressive disorders’, ‘anxiety disorders’ and ‘trauma-related disorders’.

Diagnostic manuals such as the DSM were created to provide a common diagnostic language for mental health professionals and attempt to provide a definitive list of mental health problems, including their symptoms.

The main findings of the research were:

  • Psychiatric diagnoses all use different decision-making rules
  • There is a huge amount of overlap in symptoms between diagnoses
  • Almost all diagnoses mask the role of trauma and adverse events
  • Diagnoses tell us little about the individual patient and what treatment they need

The authors conclude that diagnostic labeling represents ‘a disingenuous categorical system’.

Lead researcher Dr. Kate Allsopp, University of Liverpool, said: “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.”

This shows outlines of heads
The authors conclude that diagnostic labelling represents ‘a disingenuous categorical system’. The image is in the public domain.

Professor Peter Kinderman, University of Liverpool, said: “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.”

Professor John Read, University of East London, said: “Perhaps it is time we stopped pretending that medical-sounding labels contribute anything to our understanding of the complex causes of human distress or of what kind of help we need when distressed.”

[divider]About this neuroscience research article[/divider]

Source:
University of Liverpool
Media Contacts:
Simon Wood – University of Liverpool
Image Source:
The image is in the public domain.

Original Research: Closed access
“Heterogeneity in psychiatric diagnostic classification”. Kate Allsopp, John Read, Rhiannon Corcoran, Peter Kinderman.
Psychiatry Research. doi:10.1016/j.psychres.2019.07.005

Abstract

Heterogeneity in psychiatric diagnostic classification

The theory and practice of psychiatric diagnosis are central yet contentious. This paper examines the heterogeneous nature of categories within the DSM-5, how this heterogeneity is expressed across diagnostic criteria, and its consequences for clinicians, clients, and the diagnostic model. Selected chapters of the DSM-5 were thematically analysed: schizophrenia spectrum and other psychotic disorders; bipolar and related disorders; depressive disorders; anxiety disorders; and trauma- and stressor-related disorders. Themes identified heterogeneity in specific diagnostic criteria, including symptom comparators, duration of difficulties, indicators of severity, and perspective used to assess difficulties. Wider variations across diagnostic categories examined symptom overlap across categories, and the role of trauma. Pragmatic criteria and difficulties that recur across multiple diagnostic categories offer flexibility for the clinician, but undermine the model of discrete categories of disorder. This nevertheless has implications for the way cause is conceptualised, such as implying that trauma affects only a limited number of diagnoses despite increasing evidence to the contrary. Individual experiences and specific causal pathways within diagnostic categories may also be obscured. A pragmatic approach to psychiatric assessment, allowing for recognition of individual experience, may therefore be a more effective way of understanding distress than maintaining commitment to a disingenuous categorical system.

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  1. Lest hopelessness, frustration or anger creeps into our psyche on this matter, there are dedicated research groups working in Australia, Canada and elsewhere in developing new technologies that provide non-invasive objective measures of brain function and dysfunction.

    But research to practice is slow, costly and time-consuming while evidence is built and funding found.

    This reported issue is not new, Tom Insel, then Director of the US Institute for Mental Health put is succinctly in April 2013, just prior to the release of DSM-5, that while it was the best there was for diagnosing Mental Disorder for now, he acknowledge back then that the DSM-5 Criteria “lacked validity”.

    Rather than be forced to continue relying upon subjective qualitative assessment of reported or observed emotions and behaviours for diagnosis, these new technologies are aimed at providing diagnosing clinicians with objective digital and other biomarkers of the range of mental disorders to support them make faster and more accurate diagnoses and earlier better targetted interventions than is currently possible. And perhaps help re-define the current sets of overlapping symptomologies for the major disorders, or indeed ideally identify underlying brain or central nervous system pathologies not yet possible due to the inaccessibility and vulnerability of the living brain,

  2. The evidence is overwhelming that Psychiatry et al is engaged in massive medical fraud and yet the leading researcher of this study continues to use a misnomer (“mental health”) that is equally as meaningless and equally responsible for misleading the public about what ails them and perpetuates the problem.
    If you want the educated public to take you seriously, stop using the same lies and misinformation used by the industry pushing the DSM.

  3. I look forward to seeing what processes are put in place to a: confirm this information, b: rectify the DSM diagnoses, and c: find some universal agreement, SCIENTIFICALLY, to obtain more effective diagnoses.

  4. Knowing that psychiatry was founded by Freud has always left me… unsatisfied, but when I recently found out he was coke high well….no comment

    1. Psychiatry was not founded by Freud. You really have to go back to Pinel, or even further. psychiatry was made in the big institutions emerging in the age of enlightment. Freud was born 150 years later You could say that he was the founder of psychotherapy though. (And he was far from a coke-addict)

  5. Psychiatry is not a science, it has not scientific measurement and there is not evidence for diagnosis about personality behavior.

  6. Traumatization at the neural level is the process that permanently encodes and synaptically consolidates in the amygdala, linkages between the emotional, cognitive, autonomic and somatosensory components present during a traumatizing event. To encode as a trauma, four criteria must be met, first an event must occur, secondly the event must have meaning to the individual and create a powerful emotional response, thirdly, the neuroelectrochemical landscape of the brain must be permissive and finally the moment must be perceived as inescapable. Any one of these components, emotional, cognitive, autonomic or somatosensory, recalled either consciously or inadvertently, activates the amygdala and causes the release of stress hormones.

  7. Hmmm…always wondered why Tony would feel so justified after visiting Dr.Melfi…!!!! Obviously now I realised!!!
    Watch Sopranos..

  8. What about genetics? There tends to be a genetic component to some of these disorders.

  9. About time real scientific investigation of psychiatry took place to reveal its true nature: social control dressed up as a pseudo-science.

  10. I am agreeing with the research findings. In my opinion, psychiatry itself is not a science, it has not scientific measurement and there is no evidence for offered diagnosises in conndction with mental disorders.

    Master student in Psychology

  11. “Trauma” needs to be rigorously defined or it is also essentially “meaningless.”

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