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Psychiatry’s Efforts Over Classification

Paul R. McHugh, MD

JAMA. 2005;293:2526-2528.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Psychiatrists are reconsidering how to classify the conditions they treat. What they decide will affect who receives psychiatric services and what those services will be––matters surely of interest and concern to all physicians and health care workers. But the American Psychiatric Association has delayed a new revision of its classificatory manual so as to confront what historically has been a most obstinate challenge––how to bring its diagnoses and explanations together.¹

In the mid-20th century, Freudian psychoanalysts led the discipline by teaching that unconscious mental conflict produced psychiatric disorders. Because psychiatrists then wrapped all disorders into a single explanation (and treated them similarly), they saw little point in sharply distinguishing one manifestation of conflict from another. Although psychoanalytic influence waned in the late 1960s, the diagnostic competence of psychiatrists, needed for progress, did not improve. Even elementary census reports such as the number of patients with schizophrenia . . . [Full Text of this Article]

Author Affiliation: Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, Md.

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