Clinical diagnosis: a marker for disease?

The Journal of Nervous and Mental Disease
A Y Tien, J J Gallo

Abstract

In the science of psychiatry, a careful logic has linked items of phenomenology to diagnoses and hypothesized disease constructs. However, the resultant improved reliability of diagnostic assessment does not directly ensure the specificity and validity of diagnosis, and diagnoses are often thought of as identical to diseases. Although specificity is enhanced by the use of patterns of items of phenomenology operationalized into diagnoses to classify psychiatric disease, evidence suggests that diagnostic heterogeneity remains significant, limiting specificity. Furthermore, diagnostic concepts may bias assessments of phenomenology. Theoretically, psychiatric diseases are pathological states of neurobiological, social, and psychological processes and interactions. Although advances in social and psychological science continue, neurobiological science is advancing rapidly and is expected to contribute substantially to validity. But the relative psychometric distance and sources of measurement error between these underlying aspects of diseases and manifest phenomenology suggest that the use of clinical diagnoses, derived from phenomenology, may not be optimal as a standard from which to test neurobiological hypotheses, limiting valid...Continue Reading

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Citations

Apr 29, 1999·International Journal of Medical Informatics·G Surján
May 8, 2002·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Helen Lavretsky, Anand Kumar
Sep 5, 2006·Behavioral Sciences & the Law·Kate Diesfeld, Stefan Sjöström
Sep 17, 2013·Statistics in Medicine·Niels Smits, Matthew D Finkelman
Nov 13, 2010·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Michael B First

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