background  Psychiatric syndromes are frequently preceded by stress. Hence the question whether stress phenomena may play a causal role in the occurrence of those syndromes, or rather have to be considered as epiphenomena is vital to psychiatry.
aims  To trace whether stress diagnosis is sufficiently precise to study, in a fruitful manner, if stress may cause neurobiological disturbances associated with a certain psychopathological condition. method  Analysis of literature concerning neurobiological consequences of stress.
results  Generally speaking stress diagnosis is too inaccurate for fruitful studies into the neurobiological and psychiatric sequelae of stress.
conclusions  Certainty about the possible pathogenic role of stress in psychiatry can only be obtained by showing that stress may induce changes in brain functions thought to be associated with a particular psychiatric condition. This type of study requires refined diagnosis of stress syndromes. Generally, stress studies of this nature do not meet this requirement. The diagnostic shortcomings should be systematically addressed, in order to provide biological psychiatric stress studies with the necessary acuity.