The Vote on DSM-IV

To the Editor.—  In the September 1988 issue of the Archives, Spitzer and Williams¹ announced a "request for proposals" that would contribute to the development of DSM-IV. They then presented a research strategy in which the proposals might be structured. I offer an alternative but not mutually exclusive suggestion.One of the lingering controversies surrounding DSM-III, and likely to surround its offspring, is the dissatisfaction many researchers and clinicians have with our entire classification system and the conceptual framework that system implies. For example, our classification of psychoses is essentially that of Kraepelin²: there are two major disorders, one characterized by mood changes and minimal chronicity, and one characterized by deficits in affect, volition, and thinking and significant chronicity. We have modified this basic theme by providing alternative labels, such as delusional disorder, brief reactive psychosis, and schizoaffective disorder. However, few investigators are satisfied with these modifications.