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Psychiatric diagnoses: Why no one is satisfied
Date:2/15/2012

medicine recognizes many disorders that do not have specific causes.

"Conditions such as congestive heart failure can have many causes," Nesse said. "This doesn't bother physicians because they understand what the heart is for, and how it works to circulate blood."

Furthermore, he said, physicians recognize symptoms such as fever and pain as useful responses, not diseases.

"These symptoms can be pathological when they're expressed for no good reason, but before considering that possibility, physicians look carefully for some abnormality arousing such symptoms," Nesse said. "Likewise, the utility of anxiety is recognized, but its disorders are defined by the number and intensity of symptoms, irrespective of the cause.

"It's vital to recognize that emotions serve functions in the same way that pain, cough and fever do, and that strong negative emotions can be normal responses to challenging or anxiety-provoking situations."

So, as the DSM is revised once again, Nesse urges his colleagues and concerned members of the public to adopt realistic expectations.

"Instead of specific diseases with specific causes, many mental problems are somewhat heterogeneous overlapping syndromes that can have multiple causes," he said. "Most are not distinct species like birds or flowers. They are more like different plant communities, each with a typical collection of species. Distinguishing tundra from alpine meadow, arboreal forest and Sonoran desert is useful, even though the categories are not entirely homogenous and distinct."


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Contact: Diane Swanbrow
swanbrow@umich.edu
734-647-9069
University of Michigan
Source:Eurekalert

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