Philosophy of science and DSM‐III: Philosophical, idea‐historical and sociological perspective on diagnoses

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Abstract
The validity of a classification system is primarily a question of philosophical premise. DSM‐II is from this point of view a theoretical classification system based on hypotheses currently considered reliable and interesting and which ‐ as presupposed ‐ could not be rejected by empirical methods. The relevance or validity of this empirical approach depends on the aim of the DSM‐III. An empirical approach may facilitate communication but can only have limited success as a help for planning treatment of psychiatric disorders where motives and meaning are important factors.The choice of hypotheses and the empirically derived concepts used to construct the classification system neglects other important ways of comprehension. Although aspects of rational philosophy may be found in the DSM‐III system too, important ways of comprehension like the metaphysical approach is lacking. It is showed how this fact reflects a philosophical trend in the Western world following the Renaissance. By considering the Myth of Faust it is demonstrated how a metaphysical comprehension of life would lead to a different understanding of states of mind currently assumed to be a reflection of individual psychopathology according to empirical or rational comprehension. Thus in the end the validity of a classification system depends on the basic philosophical assumptions chosen. A choice which may be determined more by irrational and cultural forces than conscious contemplation.The content of DSM‐III or ICD is also influenced by professional interests; the needs of the society and international political factors. It is concluded that a philosophical, idea‐historical, sociological and political consciousness is necessary to secure a critical but constructive attitude towards any classification system or theory. Whatever the basic point of view may be the provision of a classification system will always exclude important dimensions of man and life. Progress in psychiatry can only occur when this fact is conscious.

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