As most readers of this website are aware, there is a great deal of resistance to the soon-to-be-released DSM-5. There is even a Boycott DSM-5 Committee established by Jack Carney, and many people are suggesting that practitioners use the World Health Organization’s (WHO’s) International Classification of Diseases (ICD) instead.
In the general context of this debate, I have come across an article by Philip Thomas, M.D. – “Pinball Wizards and the Doomed Project of Psychiatric Diagnosis.” Dr. Thomas points out that “…it’s hard to imagine that the criticisms raised about DSM-5 won’t also apply to the ICD.”
In my view this is a perfectly correct position, in that both documents assume (with no evidence) that the human problems embraced under the heading “mental illnesses” are real illnesses, and that these putative illnesses are the underlying causes of the problems. To quote Dr. Thomas: “One of the principal concerns is that both lack any sort of scientific basis.”
Dr. Thomas then goes on to critique the illness theory from the point of view of validity. In other words, he is addressing the question: does the list of mental illness diagnoses (in DSM or ICD) describe and reflect the actual reality, or is it an invention of the psychiatric community which they impose on the problems presented by their clients.
The question is fundamental because the APA claim that their taxonomy is scientific – i.e. that it accurately reflects the real world, as for instance, the Periodic Table in physics and chemistry
Dr. Thomas discusses the problems of psychiatric validity and uses the condition known as schizophrenia to illustrate his points. He reviews literature going back to 1970, and concludes:
“Although the literature abounds with studies claiming to find differences in the brains of those with a diagnosis of schizophrenia and those not so diagnosed, the results of replication studies either fail to confirm initial findings, or are inconclusive.”
“…unlike somatic medicine, psychiatric diagnoses are almost exclusively descriptive and based in symptoms rather than aetiology.”
Dr. Thomas then discusses the question of body-mind dualism, and has some interesting things to say.
I recommend the article. Dr. Thomas is a member of the Critical Psychiatry Network.