Psychiatrikē = Psychiatriki
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Review
The DSM-ICD diagnostic approach as an essential bridge between the patient and the "big data".
The use of diagnostic manuals in psychiatry is generally necessitated by the lack of tests that would corroborate psychiatric diagnosis. Criticism towards the today prevailing DSM-ICD diagnosis traditionally regards among others such problems as hyponarrativity, biologism, "death of phenomenology", and a questionably valid over-fragmentation of diagnosis. Lately, and especially after the appearance of the 5th edition of DSM (2013), criticism focuses at such issues as lack of validity, having failed to adopt a dimensional model, not adequately relying on genetics and neurobiology, and impeding, rather than facilitating, research into the etiology of mental disorders, the DSM becoming an "epistemic prison". ⋯ Moreover, the particularity of the psychiatric object, the clinical significance of the categorical approach to diagnosis, as well as the need for a "irreducible psychological level of explanation" are discussed. In our view, today, the DSM-ICD diagnosis lies between two different and potentially opposing demands and tendencies: on the one hand, the demand for the individual, subjective and phenomenological particularity of the mentally ill to be taken into consideration (a demand that sometimes underestimates the need for clinical communication); on the other hand, the (largely future) vision for more and more analysis of biological data in the name of a yet to be clarified personalized therapy (the very notion of diagnosis becoming potentially redundant). Finally, considering the particularity of the psychiatric object, we conclude that matthe DSM-ICD approach, with its categorical diagnoses and its descriptive operational criteria, despite its inherent imperfections and inadequacies, continues to have a place in psychiatry as an essential bridge/interface between clinic and research data, as a common clinical language, and as an epistemic hub; and that prerequisites for diagnostic validity should be sought both in the cells of RDoC and in those theoretical approaches which examine human subjectivity as such, included phenomenology and psychoanalysis.