Description: There are many problems as well as uses for classification schemes in psychiatry. As the authors of this important book rightly point out, there are essential differences between "disease," "illness," and "sickness." In disease, there is a known abnormal physical or physiological cause for the patient's symptoms, whereas "illness" is what the patient experiences whether or not there is any understandable physical cause of the symptom, and sickness connotes the social consequences of the symptom. Unfortunately, in psychiatry we do not, as of yet, have definable diseases. Current psychiatric classification is essentially just behavioral descriptions analogous to the classification of animals prior to Darwin a whale would have been considered a fish! This essential book covers the pros and cons of classification of mental illness in a concise yet thorough manner. Written and edited by internationally recognized experts in the field, it is a welcome addition to psychiatry.
Purpose: The purpose, according to the authors, "is to understand how these classifications (ICD-10 and DSM-IV) have been developed and to appreciate that they have both benefits and limitations..." The authors have produced a vital book for understanding the background of psychiatric classification.
Audience: The intended audience includes "all mental health professionals" as well those studying for the membership exam of the Royal College of Psychiatrists in the U.K., and the board examinations for psychiatry in the U.S.
Features: This concise book (138 pages) begins with the hazards of not having psychiatric classifications and then goes on to describe the history of international agreement on diagnosis and classification. The large-scale collaborative studies are reviewed followed by the development of the DSMs in the U.S. Problems with research methods used in diagnostic surveys are the focus of chapter 8. The issues of what a diagnosis is, the dimensional approach, and lumpers and splitters are discussed in chapter 14. Multiaxial classification and its history are discussed in chapter 16. How to use psychiatric classification and the future of classification are discussed toward the end. The six appendixes contain useful information such as the results of the U.S./U.K. Diagnostic Project and the meta effects of classifying mental disorders. The references are pertinent and timely.
Assessment: This crucial book focuses on a pivotal issue for the future of psychiatry as a medical discipline. Anyone interested in placing psychiatry on a scientific foundation needs to read this book it is a fascinating read.