Skepticism about science and medicine

In search of disinterested science

Modern Psychiatric Diagnosis is Bullshit

Posted by Henry Bauer on 2019/07/09

I use the term   “bullshit”, of course, as the appropriate description of “assertions made without regard to whether or not they have any truth value”, following the analysis of professor of philosophy Harry Frankfurt in his book On Bullshit (Princeton University Press, 2005).

Those who commit bullshit orally or in writing do, of course, often imagine that they are asserting something that is true, but they are merely parroting popular shibboleths, “what everyone knows”,  without having taken any time it to examine the evidence for themselves (see Climate change is responsible for everything, as everyone knows (but what everyone knows is usually wrong).

Extraordinary as it may seem, the professional reference work on psychiatric diagnosis, the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association and (since 2013) in its 5th edition (DSM-5), gives every appearance of having been put together without any careful attention to evidence, or for that matter to whether it makes any sense.

A couple of years ago, I pointed to the nonsense incorporated in DSM-5 about ADHD — Attention-Deficit/Hyperactivity Disorder (The banality of evil — Psychiatry and ADHD).

Now, the peer-reviewed professional journal Psychiatry Research has published a detailed analysis revealing that the diagnostic categories in DSM-5 make no sense in theory or in practice: (Allsopp et al., Heterogeneity in psychiatric diagnostic classification, Psychiatry Research 279 (2019) 15–22; https://doi.org/10.1016/j.psychres.2019.07.005).

It should suffice to offer two quotes:

“ [I]n the majority of diagnoses in both DSM-IV-TR and DSM-5 (64% and 58.3% respectively), two people could receive the same diagnosis without sharing any common symptoms.”

“[T]here are 270 million combinations of symptoms that would meet the criteria for both PTSD and major depressive disorder, and when five other commonly made diagnoses are seen alongside these two, the figure rises to one quintillion symptom combinations — more than the number of stars in the Milky Way.”

QED

Of course, the professional literature refrains from exposing its guild’s follies, the nakedness of the unclothed Emperor, to the general public, hence the article’s title is “Heterogeneity in psychiatric diagnostic classification”, unlikely to catch the eye of the uninitiated, rather than the plain “Modern psychiatric diagnosis is bullshit”, but both are saying the same thing. As George Bernard Shaw noted a century or so ago, “All professions are conspiracies against the laity”.

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