Diagnosis and the DSM A Critical Review

This book provides a critical evaluation of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Starting from a historical overview of the evolution in psychiatric diagnosis, Vanheule asserts that the diagnostic reliability of the DSM-5 is overrated: important factors that undermine its diagnostic reliability have never been sufficiently addressed and the common idea that the handbook is reliable rests on a biased interpretation of statistical data. The book argues that the DSM-5 builds on a narrow biomedical approach to mental disorders that neglects context, and proposes its replacement with a contextualizing model of mental health symptoms. Drawing from phenomenological psychiatry and Lacanian psychoanalysis, the author concludes that a reflexive account of psychopathology is urgently needed.

Stijn Vanheule is a clinical psychologist, associate professor at Ghent University, Belgium, and psychoanalyst in private practice (member New Lacanian School for Psychoanalysis). He is the author of the book The Subject of Psychosis: A Lacanian Perspective, and of multiple papers on Lacanian and Freudian psychoanalysis, psychoanalytic research into psychopathology, and clinical diagnosis.

1. Dynamics of Decision Making in the DSM: the Issue of Reliability
2. Context and Diagnosis in the DSM: the Issue of Validity