EDITORIAL: LUMPING OR SPLITTING IN DIAGNOSIS – WHAT’S THE POINT?

Classifi cation of psychiatric disorders has reached epic proportions, where new psychiatric conditions appear on a regular basis and for some inexplicable reason normal human emotions are being turned into psychiatric disorders. Natural shyness has become social phobia and not only are investigations carried out to ‘confi rm ’ such a diagnosis but also the market place is brimming with medications to ‘treat ’ social phobias. In a recent editorial in The Economist (May 19th 2007) it was commented that the number of species using the Linnaeus model has increased. For example, it was noted that the number of species of monkey, ape and lemur generally increased until the 1960s when it levelled off and then started rising again two decades later. The reason given is that a lot of subspecies have been ‘unclassifi ed ’ as species, thereby increasing the numbers. The editorial argues that it is possible that the reclassifi cation is simply rebranding because taxonomists do not always get it right the fi rst time. The increase can be justifi ed by assessing DNA make up but no such ‘objective ’ measure exists as yet in psychiatry to defi ne and classify mental illnesses. To paraphrase this editorial, a particular psychiatric disorder is what a clinician/diagnostician says it is. The fl urry of increased psychiatric diagnoses means that either we are becoming to