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What is a mental/psychiatric disorder? From DSM-IV to DSM-V

  • D. J. Stein (a1), K. A. Phillips (a2), D. Bolton (a3), K. W. M. Fulford (a4), J. Z. Sadler (a5) and K. S. Kendler (a6)...
Abstract

The distinction between normality and psychopathology has long been subject to debate. DSM-III and DSM-IV provided a definition of mental disorder to help clinicians address this distinction. As part of the process of developing DSM-V, researchers have reviewed the concept of mental disorder and emphasized the need for additional work in this area. Here we review the DSM-IV definition of mental disorder and propose some changes. The approach taken here arguably takes a middle course through some of the relevant conceptual debates. We agree with the view that no definition perfectly specifies precise boundaries for the concept of mental/psychiatric disorder, but in line with a view that the nomenclature can improve over time, we aim here for a more scientifically valid and more clinically useful definition.

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Copyright
Corresponding author
*Address for correspondence: Professor D. J. Stein, UCT Department of Psychiatry, Groote Schuur Hospital J-2, Anzio Rd, Observatory 7925, Cape Town, South Africa. (Email: dan.stein@uct.ac.za)
Linked references
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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.

D Bolton (2008). What is Mental Disorder? An Essay in Philosophy, Science, and Values. Oxford University Press: Oxford.

C Boorse (1976). What a theory of mental health should be. Journal of the Theory of Social Behaviour 6, 6184.

MB First , HA Pincus , JB Levine , JBW Williams , B Ustun , R Peele (2004). Clinical utility as a criterion for revising psychiatric diagnoses. American Journal of Psychiatry 161, 946954.

KWM Fulford (1999). Nine variations and a coda on the theme of an evolutionary definition of dysfunction. Journal of Abnormal Psychology 108, 412420.

KS Kendler (1990). Towards a scientific nosology: strengths and limitations. Archives of General Psychiatry 47, 969973.

KS Kendler (2009). An historical framework for psychiatric nosology. Psychological Medicine 39, 17.

KS Kendler , J Myers , S Zisook (2008). Does bereavement-related major depression differ from major depression associated with other stressful life events? American Journal of Psychiatry 165, 14491455.


HM van Praag (2000). Nosologomania: a disorder of psychiatry. World Journal of Biological Psychiatry 1, 151158.

JC Wakefield (1992). Disorder as harmful dysfunction: a conceptual critique of DSM-III-R's definition of mental disorder. Psychological Review 99, 232247.

P Zachar , KS Kendler (2007). Psychiatric disorders: a conceptual taxonomy. American Journal of Psychiatry 164, 557565.


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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
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