[A balanced perspective on psychiatric classification]

Abstract

Background: Professional journals in the Dutch language have played hardly any part in the recent controversies relating to DSM-5. So far, there has been no philosophical analysis of these discussions.

Aim: To discuss the current philosophical and psychiatric literature pertaining to the current debate on psychiatric classification. Our main focus will be on a scientific and realistic approach to classification.

Method: We discuss the literature from historical, scientific and philosophical perspectives.

Results: Ever since the publication of DSM-III, discussions about DSM classification and an analogous debate in philosophy have mirrored the epistemological debate between scientific realism and antirealism. Psychiatry has defended its position mainly via realism. This position, however, is strongly contested, but there are philosophical alternatives available which offer an escape from the increasingly jammed debate.

Conclusion: A different philosophical basis for psychiatric classification leaves room for pluralism, increased normative validity and a more sustainable professional legitimacy.