A new study by University of Liverpool researchers has found that psychiatric diagnoses are scientifically worthless as tools to identify discrete mental health disorders, such as anxiety disorder.
Their study involved a detailed analysis of five key chapters of the latest edition of the Diagnostic and Statistical Manual (DSM), on schizophrenia, bipolar disorder, depressive disorders, anxiety disorders, and trauma-related disorders.
Among the many findings, researchers highlighted:
- Theory and practice of diagnostic assessment is central yet contentious in psychiatry.
- DSM-5 contains heterogeneous diagnostic categories.
- Pragmatic criteria give clinical flexibility but undermine the diagnostic model.
- Trauma has a limited causal role in DSM-5, despite research evidence to the contrary.
- Psychiatric diagnoses all use different decision-making rules.
- There is a huge amount of overlap in symptoms between diagnoses.
- Almost all diagnoses mask the role of trauma and adverse events.
- Diagnoses tell us little about the individual patient and what treatment they need.
The research concludes:
“A pragmatic approach to psychiatric assessment, allowing for recognition of individual experience, may therefore be a more effective way of understanding distress than maintaining commitment to a disingenuous categorical system.”
It’s not surprising that a study has found psychiatric diagnosis to be scientifically meaningless. What is surprising is that it was published in the Journal of Psychiatry Research.
While many in the mental health community have realized this, for psychiatry in general to acknowledge it, is really something. And it’s something that could benefit those who struggle with and treat mental illness.
We’ve also had issues with the medical model being imposed on mental health. That’s because, mental illness, for the most part, involves behavioral causes and not biological, chemical, or genetic causes, which the medical model adheres to. Saying that someone has anxiety or depression because of a “medical” problem pins the tail on the wrong donkey, in our experience.
Not only is a medical-sounding label unhelpful because symptoms and treatment options are so diverse, but it also causes unnecessary hardship for many who then live their lives according to their “label,” which often deprives them of the help they could benefit from.
I’m not the only one saying this.
Lead researcher Dr. Kate Allsopp, University of Liverpool, said: “Although diagnostic labels create the illusion of an explanation they are scientifically meaningless and can create stigma and prejudice. I hope these findings will encourage mental health professionals to think beyond diagnoses and consider other explanations of mental distress, such as trauma and other adverse life experiences.”
Professor Peter Kinderman, University of Liverpool, said: “This study provides yet more evidence that the biomedical diagnostic approach in psychiatry is not fit for purpose. Diagnoses frequently and uncritically reported as ‘real illnesses’ are in fact made on the basis of internally inconsistent, confused and contradictory patterns of largely arbitrary criteria. The diagnostic system wrongly assumes that all distress results from disorder, and relies heavily on subjective judgments about what is normal.”
Professor John Read, University of East London, said: “Perhaps it is time we stopped pretending that medical-sounding labels contribute anything to our understanding of the complex causes of human distress or of what kind of help we need when distressed.”
I hope the mental health community takes these findings seriously and moves in a direction that can truly help those who have mental health challenges. A new direction – one that correctly attributes the cause, such as trauma, early life experiences, learned unhealthy coping skills, environment, etc., and provides meaningful treatment – will also help eliminate the negative stigma associated with mental illness.
There’s a reason why therapy is the “Gold Standard” treatment for many common mental illnesses, including anxiety disorder and depression. When the correct cause is identified and the resulting problems worked through, mental health problems resolve. The person can then go on to live a wonderful life free from mental illness and its adverse effects. That’s what this research is pointing out, so it’s welcome news!
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