Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
In Reply: The central argument by Drs Spitzer
and First is that for most psychiatric disorders, the etiology is unknown.
I disagree with this assumption.
They restrict their concept of etiology to “pathophysiological
processes.” But many mental disorders derive not from brain pathology
but from brain-mediated issues of assumption, accident, manner, and choice
leading to personal misdirections and misadventures, concepts that form the
core of cognitive behavioral therapy and the psychology of personality, motivation,
and social learning.
McHugh PR. Classification of Psychiatric Disorders—Reply. JAMA. 2005;294(15):1898-1900. doi:10.1001/jama.294.15.1899-b