We have arrived at our current descriptive classifications, with their many and varied array of categories, through the committee processes of DSM and ICD. To date, expert opinion, rather than solid science, has been the driver for change and this helps to explain the bewildering number of diagnostic categories and the fact that many patients meet criteria for several categories. Over the coming years, advances in neuroscience will offer the opportunity to base classification on robust evidence with diagnostic entities mapping more closely onto the workings of the brain. There are major shortcomings to the current classifications but all changes come at a cost to their users. We should be fully aware of the shortcomings and be thinking about the future. However, major changes to classification should await the emergence of robust empirical data and proven clinical utility. This will be the best way to benefit patients.
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