Diagnosis and treatment are more important than semantics say Jeffrey A Lieberman and Michael B First
Recent reports in the media have called for schizophrenia to be “abolished as a concept” because it is scientifically meaningless.1 This is not the first time that the validity of this diagnostic entity has been challenged, and it will not be the last until the cause of the disorder and its precise pathophysiology are known.
The current system of psychiatric diagnosis cannot describe definitive disease entities because of our inability to demonstrate “natural” boundaries between disorders. However, as Kendell and Jablensky point out, “thoughtful clinicians have long been aware that diagnostic categories are simply concepts, justified only by whether they provide a useful framework for organising and explaining the complexity of clinical experience in order to derive inferences about outcome and to guide decisions about treatment.”2 In this context, the charge that schizophrenia does not define a specific illness is clearly unwarranted. Although the validity of the diagnosis remains to