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Tijdschrift voor Psychiatrie 57 (2015) 6, 433 - 440


The dubious ‘reality’ of a psychiatric classification

A.C.J. Kohne

background The latest edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-5, incorporates many new classifications, but some of the classifications that appeared in earlier editions have been dropped. The article comments on and clarifies some of the items that have caused controversy.
aim To investigate whether a psychiatric classification can ever depict reality of whether it is in fact a social construct.
method The article is based on a review of the literature and provides a conceptual analysis of articles and manuals.
results An attempt has been made to distinguish between different kinds of psychiatric classifications; the ‘kinds’ can range from natural to artificial and can be practical , interactive or indifferent. This part of the study has led to the conclusion that the way in which we view the type of psychiatric disorders is determined by our entrenched ‘subject-object’ way of thinking.
conclusion The dichotomy between natural (object) and artificial (subject) should be abandoned and the ‘reality’ of a psychiatric classification should be seen as a continuum and evolutionary process.

keywords biological essentialism, classification, DSM, ICD, kinds, neurasthenia, social constructivism