Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 39
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Borda, Juan P. 2016. Self over time: another difference between borderline personality disorder and bipolar disorder. Journal of Evaluation in Clinical Practice, Vol. 22, Issue. 4, p. 603.

    Eronen, M. I. 2016. Letter to the Editor: Robustness is the kind of coherence that matters: a comment on Kendler (2015). Psychological Medicine, Vol. 46, Issue. 07, p. 1563.

    Kendler, K S 2016. The transformation of American psychiatric nosology at the dawn of the twentieth century. Molecular Psychiatry, Vol. 21, Issue. 2, p. 152.

    Lakeman, Richard and Cutcliffe, John 2016. Diagnostic Sedition: Re-Considering the Ascension and Hegemony of Contemporary Psychiatric Diagnosis. Issues in Mental Health Nursing, Vol. 37, Issue. 2, p. 125.

    Rose, N. 2016. Neuroscience and the future for mental health?. Epidemiology and Psychiatric Sciences, Vol. 25, Issue. 02, p. 95.

    Sepulveda, Esteban Franco, José G. Trzepacz, Paula T. Gaviria, Ana M. Meagher, David J. Palma, José Viñuelas, Eva Grau, Imma Vilella, Elisabet and de Pablo, Joan 2016. Delirium diagnosis defined by cluster analysis of symptoms versus diagnosis by DSM and ICD criteria: diagnostic accuracy study. BMC Psychiatry, Vol. 16, Issue. 1,

    Stein, Jacob Y. Wilmot, Dayna V. and Solomon, Zahava 2016. Does one size fit all? Nosological, clinical, and scientific implications of variations in PTSD Criterion A. Journal of Anxiety Disorders,

    Amini, Mehdi Pourshahbaz, Abbas Mohammadkhani, Parvaneh Khodaie Ardakani, Mohammad Reza and Lotfi, Mozhgan 2015. The DSM-5 Levels of Personality Functioning and Severity of Iranian Patients With Antisocial and Borderline Personality Disorders. Iranian Red Crescent Medical Journal, Vol. 17, Issue. 8,

    Borda, Juan P. and Sass, Louis A. 2015. Phenomenology and neurobiology of self disorder in schizophrenia: Primary factors. Schizophrenia Research, Vol. 169, Issue. 1-3, p. 464.

    Cooray, Sherva Elizabeth Bhaumik, Sab Roy, Ashok Devapriam, John Rai, Rahul and Alexanger, Regi 2015. Intellectual disability and the ICD-11: towards clinical utility?. Advances in Mental Health and Intellectual Disabilities, Vol. 9, Issue. 1, p. 3.

    Lai, Meng-Chuan Lombardo, Michael V. Auyeung, Bonnie Chakrabarti, Bhismadev and Baron-Cohen, Simon 2015. Sex/Gender Differences and Autism: Setting the Scene for Future Research. Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 54, Issue. 1, p. 11.

    Möller, Hans-Jürgen Bandelow, Borwin Bauer, Michael Hampel, Harald Herpertz, Sabine C. Soyka, Michael Barnikol, Utako B. Lista, Simone Severus, Emanuel and Maier, Wolfgang 2015. DSM-5 reviewed from different angles: goal attainment, rationality, use of evidence, consequences—part 1: general aspects and paradigmatic discussion of depressive disorders. European Archives of Psychiatry and Clinical Neuroscience, Vol. 265, Issue. 1, p. 5.

    Morey, Leslie C. Benson, Kathryn T. Busch, Alexander J. and Skodol, Andrew E. 2015. Personality Disorders in DSM-5: Emerging Research on the Alternative Model. Current Psychiatry Reports, Vol. 17, Issue. 4,

    Sass, Louis A. and Borda, Juan P. 2015. Phenomenology and neurobiology of self disorder in schizophrenia: Secondary factors. Schizophrenia Research, Vol. 169, Issue. 1-3, p. 474.

    Sepulveda, Esteban Franco, José G. Trzepacz, Paula T. Gaviria, Ana M. Viñuelas, Eva Palma, José Ferré, Gisela Grau, Imma and Vilella, Elisabet 2015. Performance of the Delirium Rating Scale-Revised-98 Against Different Delirium Diagnostic Criteria in a Population With a High Prevalence of Dementia. Psychosomatics, Vol. 56, Issue. 5, p. 530.

    de Leon, J. 2014. ¿Es hora de despertar a la Bella Durmiente? En 1980, la psiquiatría europea cayó en un profundo sueño. Revista de Psiquiatría y Salud Mental, Vol. 7, Issue. 4, p. 186.

    de Leon, Jose 2014. Is it time to awaken Sleeping Beauty? European psychiatry has been sleeping since 1980. Revista de Psiquiatría y Salud Mental (English Edition), Vol. 7, Issue. 4, p. 186.

    de León, José 2014. ¿Es científica la psiquiatría? Carta al residente de psiquiatría del siglo xxi. Psiquiatría Biológica, Vol. 21, Issue. 1, p. 14.

    Greeson, Jeffrey Garland, Eric L. and Black, David 2014. The Wiley Blackwell Handbook of Mindfulness.

    Kandratavicius, Ludmyla Hallak, Jaime Eduardo and Leite, Joao Pereira 2014. What are the similarities and differences between schizophrenia and schizophrenia-like psychosis of epilepsy? A neuropathological approach to the understanding of schizophrenia spectrum and epilepsy. Epilepsy & Behavior, Vol. 38, p. 143.


An historical framework for psychiatric nosology

  • K. S. Kendler (a1)
  • DOI:
  • Published online: 16 April 2009

This essay, which seeks to provide an historical framework for our efforts to develop a scientific psychiatric nosology, begins by reviewing the classificatory approaches that arose in the early history of biological taxonomy. Initial attempts at species definition used top-down approaches advocated by experts and based on a few essential features of the organism chosen a priori. This approach was subsequently rejected on both conceptual and practical grounds and replaced by bottom-up approaches making use of a much wider array of features. Multiple parallels exist between the beginnings of biological taxonomy and psychiatric nosology. Like biological taxonomy, psychiatric nosology largely began with ‘expert’ classifications, typically influenced by a few essential features, articulated by one or more great 19th-century diagnosticians. Like biology, psychiatry is struggling toward more soundly based bottom-up approaches using diverse illness characteristics. The underemphasized historically contingent nature of our current psychiatric classification is illustrated by recounting the history of how ‘Schneiderian’ symptoms of schizophrenia entered into DSM-III. Given these historical contingencies, it is vital that our psychiatric nosologic enterprise be cumulative. This can be best achieved through a process of epistemic iteration. If we can develop a stable consensus in our theoretical orientation toward psychiatric illness, we can apply this approach, which has one crucial virtue. Regardless of the starting point, if each iteration (or revision) improves the performance of the nosology, the eventual success of the nosologic process, to optimally reflect the complex reality of psychiatric illness, is assured.

Corresponding author
*Address for correspondence: K. S. Kendler, M.D., Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University Medical School, Box 980126, 800 E. Leigh Street, Room 1-123, Richmond, VA 23298-0126, USA. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

H Chang (2004). Inventing Temperature: Measurement and Scientific Progress. Oxford University Press: New York, NY.

P Dear (2006). The Intelligibility of Nature: How Science Makes Sense of the World. The University of Chicago Press: Chicago, IL.

JP Feighner , E Robins , SB Guze , RA Woodruff Jr., G Winokur , R Munoz (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26, 5763.

KS Kendler (1990). Toward a scientific psychiatric nosology. Strengths and limitations. Archives of General Psychiatry 47, 969973.

A Kleinman (2004). Culture and depression. New England Journal of Medicine 351, 951953.

A Kraam (2008). Karl Ludwig Kahlbaum by Dr. Ewald Hecker (1899). History of Psychiatry 19, 7780.

TS Kuhn (1996). The Structure of Scientific Revolutions. University of Chicago Press: Chicago, IL.

JM Murphy (1976). Psychiatric labeling in cross-cultural perspective. Science 191, 10191028.

PR Sloan (1972). John Locke, John Ray, and the problem of the natural system. Journal of the History of Biology 5, 153.

RL Spitzer , J Endicott , E Robins (1978). Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry 35, 773782.

J Westermeyer (1979). Folk concepts of mental disorder among the Lao: continuities with similar concepts in other cultures and in psychiatry. Cultural and Medical Psychiatry 3, 301317.

JK Wing , JL Birley , JE Cooper , P Graham , AD Isaacs (1967). Reliability of a procedure for measuring and classifying ‘present psychiatric state’. British Journal of Psychiatry 113, 499515.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *