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What is the future for mental illness classifications? A summary of recent Anglo-American criticism Volume 89, issue 4, Avril 2013

Author
Neurobiologiste, directeur de recherche au CNRS, Université Bordeaux-II, Institut des maladies neurodégénératives, CNRS UMR 5293, 146, rue Léo-Saignat, 33076 Bordeaux, France

In recent years, senior representatives of Anglo-American psychiatry have vigorously criticized the American classification of mental illnesses, the DSM, but these criticisms are not very well known in France. This paper proposes a synthesis. They show that the reliability of DSM-IV is satisfactory for severe pathologies whereas it is mediocre for others. In addition, its validity is weak since most patients suffer from a combination of mental health disorders supposedly distinct and the supposed distinct limit between normal and pathological has proven to be very inaccurate in clinical practice. This lack of scientificity merely reflects our ignorance regarding mental disorders. The DSM is however widely used by a variety of caregivers. Based on American studies, this article then presents some of the consequences of the current DSM.