Epidemiology and Psychiatric Sciences

Special Article

The disease entity in psychiatry: fact or fiction?

A. Jablenskya1 c1

a1 The University of Western Australia, Perth, Australia


Background. The current debate concerning the forthcoming revisions of the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) lacks sufficient historical perspective on groundwork concepts in psychiatry, such as the nature of the disease entity, categorical typologies, dimensional models and their validity and utility.

Objective. To offer an overview of the evolution and metamorphoses of the conceptual basis of classification in psychiatry, with particular focus on psychotic disorders.

Method. Discursive, proceeding from history of ideas to a critique of present dilemmas.

Results. Much of the present-day discussion of basic issues concerning the classification of mental disorders is a replay of debates that took place in the earlier periods of scientific psychiatry.

Conclusion. The mainstream nosological paradigm adopted in psychiatry since early 20th century is in need to be critically examined and transcended with the help of concepts and methodological tools available today.

(Received November 06 2011)

(Revised February 05 2012)

(Accepted February 06 2012)

(Online publication May 25 2012)


c1 Address for correspondence: Professor A. Jablensky, The University of Western Australia, Perth, Australia. (Email: assen.jablensky@uwa.edu.au)


This article is an abridged and modified version of Chapter 5: Jablensky, A. (2012) The nosological entity in psychiatry: a historical illusion or a moving target? In Philosophical Issues in Psychiatry II (ed KS Kendler and J Parnas), pp. 77–94, published by Oxford University Press, http://www.oup.com, reproduced with permission.