February 1974

Toward a Scientific Psychiatric NosologyConceptual and Pragmatic Issues

Author Affiliations

From the Department of Psychiatry, Temple University Health Sciences Center, Philadelphia.

Arch Gen Psychiatry. 1974;30(2):154-161. doi:10.1001/archpsyc.1974.01760080014002

Psychiatric identity may be considered as a reflection of the adequacy of the nosology used in psychiatry. The Diagnostic and Statistical Manual of Mental Disorders (DSM-II) is considered inadequate from a number of standpoints.

The development of valid nosology in psychiatry depends on an understanding of the concepts of arbitrary focus, differentiation and standardization, time framing and reductionism, and systems. These principles provide conceptual guidelines in the development of nosology and DSM-II is analyzed according to each principle to point out its shortcomings.

Various nosologies are valid for development and what kind depends on the use to be made of the nosology, ie, the pragmatics of nosology. Three types of nosology are discussed: interventional, descriptive, and administrative.

Finally, the implications of the foregoing are discussed with reference to new nosologic systems, and in reference to their role in establishing new limits of identity for psychiatry.