Why do we need a diagnosis? Maybe a syndrome is enough?

The recent publication of the Diagnostic and Statistical Manual of Mental Disorders 5.1 by the American Psychiatric Association, and the continuing work of the World Health Organization on the 11th revision of the International Classification of Diseases raises once more the question of the need for, the use, and the usefulness of diagnosis in psychiatry The fact that, despite significant advances of science, we are still uncertain about the causes and pathogenesis of mental disorders seems to support the notion that it would be better to use syndromes instead of diagnoses, or go even further and describe mental states in health and disease by a series of ratings on key dimensions of mental functioning. Another option that has also received some backing is the presentation of the universe of mental illness by a series of disease prototypes which, it is argued, would be particularly attractive to practising clinicians. The paper discusses these issues and ends by supporting the use of different ways of presenting mental illness, depending on the purpose of the description.