THE DEVELOPMENT of effective Psychopharmacological agents confronted the psychiatric profession with the inadequacy of its diagnostic system for the provision of rational indications and contraindications for drug therapy. Within each standard diagnostic group there are wide variations in drug-induced behavioral reactions. Therefore, clinical treatment with psychotropic agents has been governed by rule of thumb modified by trial and error. This paper will emphasize the utility of psychiatric diagnosis when appropriately modified for prediction of treatment outcome.
The issue of the prediction of drug effect is one of considerable practical and theoretical importance. It is difficult to arrive at generally valid conclusions predictive of drug effect from clinical empiricism because of spontaneous remissions, uncontrolled fluctuations of life circumstance, and the meager abilities of many psychiatric patients to describe objectively their level of cognitive, affective, and social functioning. Most systematic attempts to predict treatment