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By Ian Pitchford

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As Hobson and Leonard explain This official classification system makes it tempting to pigeonhole patients and prescribe psychiatric drugs by rote… Of course, most experienced psychiatrists realize that mental ills defy this sort of pigeonholing and respond poorly to such cavalier treatment. Even so, DSM-IV’s authoritative status and detailed nature tends to promote the idea that rote diagnosis and pill-pushing are acceptable (Hobson & Leonard, 2001, p. 125). - 46 - ‘Schizophrenia’ as an Exemplar of DSM Categorisation ‘Schizophrenia’ has been described by one critic as ‘the sacred symbol of psychiatry’ (Szasz, 1976) as it is often regarded as the prototypical example of a genuine mental disorder.

Overall, I concur with Valenstein’s assessment We are currently in a position where it is clear that none of our theories is right, but we do not know what to replace them with. In the meantime, there are a number of groups that have their own reasons for promoting the theories and glossing over their serious deficiencies, rather than admitting that we really do not know what causes mental disorders or why drugs are sometimes helpful… it is indeed amazing how little biochemical theories of mental disorders have changed over the last half-century… Is this conservatism the result of having been fortunate in getting the theories essentially right at the outset?

The standard system of classification now employed in much of clinical practice and research in the United States and throughout the world is the updated version of the early manual devised by the American Psychiatric Association and now published under the title Diagnostic and Statistical Manual of Mental Disorders (1952; 1968; 1980; 1987; 1994). The latest version, DSM-IV is said to be ‘fully compatible with… ICD-10’ (American Psychiatric Association, 1994, p. xxi), which is the International Classification of Diseases and Related Health Problems published by the World Health Organization.

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