Classifying Madness: A Philosophical Examination of the Diagnostic and Statistical Manual of Mental Disorders (Philosophy and Medicine Book 86)

This book is about the Diagnostic and Statistical Manual of Mental Disorders, more commonly known as the D.S.M. The D.S.M. is published by the American Psychiatric Association and aims to list and describe all mental disorders. The D.S.M. is embedded in mental health care at every turn. In the U.S., hospital records note a D.S.M. diagnosis and medical insurance companies demand D.S.M. codes before they will consider reimbursing for the cost of care. Worldwide, research papers are couched in D.S.M. terminology and pharmaceutical companies list the D.S.M. diagnoses that their drugs treat. Mental health professionals, and their patients, can not avoid being affected by the D.S.M. The D.S.M. is important, but it is also controversial. While its publishers claim that the D.S.M. is a scientific classification system based on sound data, many have doubts. Big business has interests in the D.S.M. Perhaps the D.S.M. has been distorted by pressures stemming from insurance companies, or from pharmaceutical companies? Others are concerned that whether a condition is classified as a mental disorder depends too greatly on social and political factors. More conceptual worries are also frequent. If classification requires a theory, and if mental disorders are poorly understood, then a sound classification system may be presently unobtainable. Possibly even attempting to construct a classification system that "cuts nature at the joints" is conceptually na?ve. Maybe types of mental disorder are radically unlike, say, chemical elements, and simply fail to have a natural structure. Classifying Madness offers a sustained philosophical critique of the D.S.M. that addresses these concerns. The first half of the book asks whether the project of constructing a classification of mental disorders that reflects natural distinctions makes sense. I conclude that it does. The second half of the book addresses epistemic worries. Even supposing a natural classification system to be possible in principle, there may be reasons to be suspicious of the categories included in the D.S.M. I examine the extent to which the D.S.M. depends on psychiatric theory, and look at how it has been shaped by social and financial factors. I aim to be critical of the D.S.M. without being antagonistic towards it. Ultimately, however, I am forced to conclude that although the D.S.M. is of immense practical importance, it is not on track to become the best possible classification of mental disorders. Classifying Madness will be of interest to both mental health professionals and to philosophers interested in classification in science. The possibility that there may be philosophical difficulties with the D.S.M. has become a commonplace in the mental health literature, and Classifying Madness offers mental health professionals an opportunity to explore suspicions that there might be conceptual problems with the D.S.M. For philosophers, this book aims to contribute to debates in the philosophy of science concerning natural kinds, the theory-ladenness of classification, and the effect of sociological factors in science. These issues are normally approached via a consideration of the natural sciences and, as will be seen, approaching them via a consideration of psychiatry helps shed new light on old problems.

The "Diagnostic and Statistical Manual of Mental Disorders" is important, but it is also controversial. While its publishers claim that the D.S.M. is a scientific classification system based on sound data, many have doubts. Big business has interests in the D.S.M. Perhaps the D.S.M. has been distorted by pressures stemming from insurance companies, or from pharmaceutical companies? Others are concerned that whether a condition is classified as a mental disorder depends too greatly on social and political factors. More conceptual worries are also frequent. If classification requires a theory, and if mental disorders are poorly understood, then a sound classification system may be presently unobtainable. Possibly even attempting to construct a classification system that "cuts nature at the joints" is conceptually naïve. Maybe types of mental disorder are radically unlike, say, chemical elements, and simply fail to have a natural structure.

Classifying Madness offers a sustained philosophical critique of the D.S.M. that addresses these concerns. The first half of the book asks whether the project of constructing a classification of mental disorders that reflects natural distinctions makes sense. I conclude that it does. The second half of the book addresses epistemic worries. Even supposing a natural classification system to be possible in principle, there may be reasons to be suspicious of the categories included in the D.S.M. I examine the extent to which the D.S.M. depends on psychiatric theory, and look at how it has been shaped by social and financial factors. I aim to be critical of the D.S.M. without being antagonistic towards it. Ultimately, however, I am forced to conclude that although the D.S.M. is of immense practical importance, it is not on track to become the best possible classification of mental disorders.

This book is about the Diagnostic and Statistical Manual of Mental Disorders, more commonly known as the D.S.M. The D.S.M. is published by the American Psychiatric Association and aims to list and describe all mental disorders. Within its pages can be found diagnostic criteria for types of depression, types of schizophrenia, eating disorders, anxiety disorders, phobias, sleeping disorders, and so on. Also included are less familiar, and more controversial, conditions: Mathematics Disorder, Caffeine Intoxication, Nicotine Dependence, Nightmare Disorder. It must be admitted that the D.S.M. is not an exciting read. Its pages follow a standard format: Each disorder has a numerical code. This is followed by a description of the disorder, which includes information regarding prevalence, course, and differential diagnosis. Finally explicit criteria that patients must meet to receive the diagnosis are listed. These generally include lists of the symptoms that must be present, restrictions as to the length of time that the symptoms must have been troublesome, and clauses that state that the symptoms must not be better accounted for by some other condition. "Classifying Madness examines the conceptual foundations of the D.S.M., the main classification of mental disorders used by psychiatrists worldwide. It will be of interest to both mental health professionals and to philosophers interested in classification in science. The D.S.M. has become extremely controversial, and the possibility that there may be philosophical difficulties with it has become a commonplace in the mental health literature. Classifying Madness offers mental health professionals an opportunity to explore suspicions that there might be conceptual problems with the D.S.M. For philosophers, this book aims to contribute to debates in the philosophy of science concerning natural kinds, the theory-ladenness of classification, and the effect of sociological factors in science. These issues are normally approached via a consideration of the natural sciences and, as will be seen, approaching them via a consideration of psychiatry helps shed new light on old problems."--BOOK JACKET About the Diagnostic and Statistical Manual of Mental Disorders (DSM) that aims to list and describe all mental disorders, and is extremely influential in the US health system. This book offers a sustained philosophical critique of the DSM that addresses concerns about its scientific basis, pressure from big business, and conceptual issues