Distinguishing between the validity and utility of psychiatric diagnoses.

@article{Kendell2003DistinguishingBT,
  title={Distinguishing between the validity and utility of psychiatric diagnoses.},
  author={Robert E. Kendell and Assen A. Jablensky},
  journal={The American journal of psychiatry},
  year={2003},
  volume={160 1},
  pages={
          4-12
        }
}
OBJECTIVE The meaning of the terms "validity" and "utility" as they apply to psychiatric diagnoses is examined. METHOD The authors discuss the concepts of validity, utility, and disease; review assumptions that have been made about mental disorders as disease entities; and examine the evidence that mental disorders are separated from one another and from normality by natural boundaries (zones of rarity). RESULTS Despite historical and recent assumptions to the contrary, there is little… 
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References

SHOWING 1-10 OF 56 REFERENCES
Whither Psychiatric Diagnosis
  • A. Frances, H. Egger
  • Psychology, Medicine
    The Australian and New Zealand journal of psychiatry
  • 1999
TLDR
The development of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), its purposes and limitations, and the psychiatric nosologies which may emerge from advances in psychiatric research and which may supersede the current classification system are described.
Toward DSM-V and the classification of psychopathology.
TLDR
The authors discuss issues that cut across individual diagnostic categories and that should receive particular attention in DSM-V: (a) the process by which the diagnostic manual is developed, (b) the differentiation from normal psychological functioning, (c) the differentiated among diagnostic categories, (d) cross-sectional vs. longitudinal diagnoses, and (e) the role of laboratory instruments.
Limitations of diagnostic criteria and assessment instruments for mental disorders. Implications for research and policy.
TLDR
The health policy implications of discrepant and/or high prevalence rates for determining treatment need in the context of managed care definitions of "medical necessity" are discussed.
Symptom profiles of psychiatric disorders based on graded disease classes: an illustration using data from the WHO International Pilot Study of Schizophrenia.
TLDR
A GoM based psychiatric classification might more clearly identify core disease processes than conventional classification models by filtering the confounding effects of individual heterogeneity from pure type definitions.
The impact of diagnostic hierarchies on prevalence estimates for psychiatric disorders.
Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia.
TLDR
It was shown by follow-up and family studies that poor prognosis cases can be validly separated clinically from good prediction cases, and the authors conclude that good prognosis "schizophrenia" is not mild schizophrenia, but a different illness.
On values in recent American psychiatric classification.
TLDR
The DSM-IV, like its predecessors, will be a major influence on American psychiatry, as a consequence, continuing analysis of its assumptions is essential and implications for psychiatric science and future DSM classifications are discussed.
A New Conceptual Paradigm from Genetics and Psychobiology for the Science of Mental Health
  • C. R. Cloninger
  • Psychology, Medicine
    The Australian and New Zealand journal of psychiatry
  • 1999
TLDR
An alternative psychobiologically based paradigm is described based on the model that mental health and its disorders are emergent properties of complex interactions among multidimensional neuroadaptive systems and permits an explicit definition of optimum mental health.
Frequency and differential diagnosis of depressive syndromes in schizophrenia.
The frequency, differential diagnosis, and implications of depression occurring in the course of schizophrenia are considered in light of recently reported findings from a follow-up and family study
Diagnosis and prognosis in schizophrenia.
TLDR
It is shown that schizophrenia was a discrete disorder by using a quantitative clinical scale that discriminated schizophrenics from other subjects in a prospective follow-up and family study of 500 psychiatric outpatients, and scale scores were valuable for quantifying the certainty of diagnosis and predicting outcome.
...
...