Saturday, July 27, 2013

A philosopher reviews DSM-5

An excerpt from the review  " The NIMH said it would stop using DSM because it lacked ‘validity’. In fact the DSM-5 has made a great effort to make sure it meets the criteria for what it sees as validity.* That is not my problem. I am making a claim grounded more on logic than on medicine. Sauvages’s dream of classifying mental illness on the model of botany was just as misguided as the plan to classify the chemical elements on the model of botany. There is an amazingly deep organisation of the elements – the periodic table – but it is quite unlike the organisation of plants, which arises ultimately from descent. Linnaean tables of elements (there were plenty) did not represent nature.

The DSM is not a representation of the nature or reality of the varieties of mental illness, and this is a far more radical criticism of it than Insel’s claim that the book lacks ‘validity’. I am saying it is founded on a wrong appreciation of the nature of things. It remains a very useful book for other purposes. It is essential to have something like this for the bureaucratic needs of paying for treatment and assessing prevalence."

At one point Ian Hacking says "More and more kinds of behaviour are now being filed as disorders, opening up vast fields of profit for drug companies. I shall discuss none of these important issues, ..." These aspects are discussed by Ethan Watters in his book 'Crazy Like Us' and the articles like The Americanization of Mental Illness. See also the links in this post.

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