Measuring the validity of psychiatric diagnoses is still an unsolved
problem. Yet, revisions of the Diagnostic and Statistical
Manual of Mental Disorders and of chapter V of the International Classification of Diseases are now under way, with the
hope of improving the validity of the current systems. This article suggests
data that could be used to assist in this goal. This article has 3 objectives.
(1) To show that although the validity of the interview protocols used in
collecting epidemiologic survey data has not itself been proven, the data
banks they have collected are well suited to raising questions about the validity
of the existing diagnostic nomenclature. This is the case because they faithfully
operationalize the current nomenclature in large interview studies of diverse
general populations. (2) To show the kinds of changes that appropriate analysis
of these data may suggest as ways to improve the validity of the nomenclature.
(3) To show how suggested changes that emerge from such analyses should be
tested to learn whether they actually improve validity before they are implemented.
The data sets from large epidemiologic studies have hardly been tapped for
testing the validity of the current nomenclature. It is feasible to use them
for this purpose because they are in the public domain and because they assess
the presence or absence of each of the criteria in the manuals before applying
the manuals’ algorithms for combining them to make a diagnosis. Thus,
these data banks allow exploration of the effects of combining and splitting
diagnoses, of omitting criteria or reweighting them, and of choosing altered
algorithms with respect to age at onset, number of symptoms, and duration
of episodes. Assessing the consequences of these alterations can be tested
by applying some of the criteria of Robins and Guze and Kendell.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Thank you for submitting a comment on this article. It will be reviewed by JAMA Psychiatry editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 14
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Users' Guides to the Medical Literature
Are the Results of the Study Valid?
Users' Guides to the Medical Literature
Are the Recommendations Valid?
All results at
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.