0
October 1990, Vol 47, No. 10 >
Article | October 1990

Toward a Scientific Psychiatric Nosology: Title and subTitle BreakStrengths and Limitations

Kenneth S. Kendler, MD
[+] Author Affiliations

Accepted for publication December 21, 1989.

Reprint requests to Box 710 MCV Station, Richmond, VA 23298-0710 (Dr Kendler).


Arch Gen Psychiatry. 1990;47(10):969-973. doi:10.1001/archpsyc.1990.01810220085011
Text Size: A A A
Published online
Article
References
Comments

• A consensus is emerging that psychiatric nosology should become more "scientific." The application of the scientific method to psychiatric nosology has a number of important advantages, including (1) providing a clear criterion by which to evaluate nosologic proposals, (2) preventing rapid changes due to nosologic "fashions" not supported by research findings, (3) increasing the prestige and acceptability of our nosologic system to individuals outside of psychiatry, and (4) optimizing the reliability and validity of our diagnostic constructs. However, many critical issues confronting nosologists are fundamentally nonempirical and cannot be addressed by the scientific method. Examples of such issues include (1) disagreements about the proper construct for a psychiatric disorder; (2) the interpretation of results when different validators provide opposing answers; (3) defining how different syndromes must be to be considered subtypes of the same disorder, distinct disorders within the same overall category, or entirely independent disorders; and (4) the proper balance of reliability and validity. The optimal use of the scientific method in our nosologic process requires a recog nition of both its strengths and its limitations.

REFERENCES

1 +
Pinel P; Davis DD, trans. A Treatise on Insanity . Sheffield, England: W Todd; 1806;.
2 +
Griesinger W; Robertson CL, Rutherford J, trans. Mental Pathology and Therapeutics . London, England: New Syndenham Society; 1867;.
3 +
Kraepelin E; Diefendorf AF, trans-ed. Clinical Psychiatry: A Textbook for Students and Physicians . 7th ed. New York, NY: Macmillan Publishing Co Inc; 1923;.
4 +
Bleuler E; Brill AA, trans. Textbook of Psychiatry . New York, NY: Macmillan Publishing Co Inc; 1924;.
5 +
Schneider K. Clinical Psychopathology . New York, NY: Grune & Stratton Inc; 1959;.
6 +
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders . Washington, DC: American Psychiatric Association; 1952;.
7 +
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders , Second Edition. Washington, DC: American Psychiatric Association; 1968;.
8 +
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders , Third Edition. Washington, DC: American Psychiatric Association; 1980;.
9 +
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders , Revised Third Edition. Washington, DC: American Psychiatric Association; 1987;.
10 +
Robins E, Guze SB.  Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia . Am J Psychiatry . 1970;;126:983-987.
11 +
Kendler KS.  The nosologic validity of paranoia (simple delusional disorder): a review . Arch Gen Psychiatry . 1980;;37:699-706.
12 +
Kendler KS.  Diagnostic approaches to schizotypal personality disorder: a historical perspective . Schizophr Bull . 1985;;11:538-553.
13 +
Jacobsberg LB, Hymowitz P, Barasch A, Frances AJ.  Symptoms of schizotypal personality disorder . Am J Psychiatry . 1986;;143:1222-1227.
14 +
Gunderson JG, Siever LJ, Spaulding E.  The search for a schizotype: crossing the border again . Arch Gen Psychiatry . 1983;;40:15-22.
15 +
Kendler KS, Gruenberg AM, Tsuang MT.  Outcome of schizophrenic subtypes defined by four diagnostic systems . Arch Gen Psychiatry . 1984;;41:149-154.
16 +
Kendler KS, Gruenberg AM, Tsuang MT.  Subtype stability in schizophrenia . Am J Psychiatry . 1985;;142:827-832.
17 +
Gruenberg AM, Kendler KS, Tsuang MT.  Reliability and concordance in the subtyping of schizophrenia . Am J Psychiatry . 1985;;142:1355-1358.
18 +
Kendler KS, Gruenberg AM, Tsuang MT.  A family study of the subtypes of schizophrenia . Am J Psychiatry . 1988;;145:57-62.
19 +
Tsuang MT, Winokur G.  Criteria for subtyping schizophrenia: clinical differentiation of hebephrenic and paranoid schizophrenia . Arch Gen Psychiatry . 1974;;31:43-47.
20 +
Mental Disorders: Glossary and Guide to Their Classification in Accordance With the Ninth Revision of the International Classification of Diseases. Geneva, Switzerland: World Health Organization; 1978.
21 +
Kendler KS.  Schizophrenia and other psychotic disorders . In: Skodol AE, Spitzer RL, eds. An Annotated Bibliography of DSM-III . Washington, DC: American Psychiatric Association Press; 1987;:85-94.

First Page Preview

First page PDF preview

Figures

Tables

Interactive Graphics

Video

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

1 +
Pinel P; Davis DD, trans. A Treatise on Insanity . Sheffield, England: W Todd; 1806;.
2 +
Griesinger W; Robertson CL, Rutherford J, trans. Mental Pathology and Therapeutics . London, England: New Syndenham Society; 1867;.
3 +
Kraepelin E; Diefendorf AF, trans-ed. Clinical Psychiatry: A Textbook for Students and Physicians . 7th ed. New York, NY: Macmillan Publishing Co Inc; 1923;.
4 +
Bleuler E; Brill AA, trans. Textbook of Psychiatry . New York, NY: Macmillan Publishing Co Inc; 1924;.
5 +
Schneider K. Clinical Psychopathology . New York, NY: Grune & Stratton Inc; 1959;.
6 +
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders . Washington, DC: American Psychiatric Association; 1952;.
7 +
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders , Second Edition. Washington, DC: American Psychiatric Association; 1968;.
8 +
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders , Third Edition. Washington, DC: American Psychiatric Association; 1980;.
9 +
American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders , Revised Third Edition. Washington, DC: American Psychiatric Association; 1987;.
10 +
Robins E, Guze SB.  Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia . Am J Psychiatry . 1970;;126:983-987.
11 +
Kendler KS.  The nosologic validity of paranoia (simple delusional disorder): a review . Arch Gen Psychiatry . 1980;;37:699-706.
12 +
Kendler KS.  Diagnostic approaches to schizotypal personality disorder: a historical perspective . Schizophr Bull . 1985;;11:538-553.
13 +
Jacobsberg LB, Hymowitz P, Barasch A, Frances AJ.  Symptoms of schizotypal personality disorder . Am J Psychiatry . 1986;;143:1222-1227.
14 +
Gunderson JG, Siever LJ, Spaulding E.  The search for a schizotype: crossing the border again . Arch Gen Psychiatry . 1983;;40:15-22.
15 +
Kendler KS, Gruenberg AM, Tsuang MT.  Outcome of schizophrenic subtypes defined by four diagnostic systems . Arch Gen Psychiatry . 1984;;41:149-154.
16 +
Kendler KS, Gruenberg AM, Tsuang MT.  Subtype stability in schizophrenia . Am J Psychiatry . 1985;;142:827-832.
17 +
Gruenberg AM, Kendler KS, Tsuang MT.  Reliability and concordance in the subtyping of schizophrenia . Am J Psychiatry . 1985;;142:1355-1358.
18 +
Kendler KS, Gruenberg AM, Tsuang MT.  A family study of the subtypes of schizophrenia . Am J Psychiatry . 1988;;145:57-62.
19 +
Tsuang MT, Winokur G.  Criteria for subtyping schizophrenia: clinical differentiation of hebephrenic and paranoid schizophrenia . Arch Gen Psychiatry . 1974;;31:43-47.
20 +
Mental Disorders: Glossary and Guide to Their Classification in Accordance With the Ninth Revision of the International Classification of Diseases. Geneva, Switzerland: World Health Organization; 1978.
21 +
Kendler KS.  Schizophrenia and other psychotic disorders . In: Skodol AE, Spitzer RL, eds. An Annotated Bibliography of DSM-III . Washington, DC: American Psychiatric Association Press; 1987;:85-94.

Correspondence

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems