Psychiatric diagnosis: impersonal, imperfect and important

Psychiatric diagnosis is in the spotlight following the recent publication of DSM-5. In this article we consider both the benefits and limitations of diagnosis in psychiatry. The use of internationally recognised diagnoses, although insufficient alone, is part of a psychiatrist’s professional responsibility to provide high-quality, evidence-based care for patients. The place of diagnosis in psychiatry is once again in the spotlight because of the recent publication of the latest revision of the US classification scheme DSM-5.1 Criticisms of DSM-5 include the overmedicalisation of normal experiences,2 the integrity of those involved3 and extend to broader criticisms of the conceptual basis of psychiatric diagnosis4 and even the need for diagnosis at all.5,6 This is a timely moment, therefore, to set out why diagnosis is important in modern psychiatric practice and to be clear about both the benefits and limitations. It is also important to be clear that diagnosis alone is insufficient in conceptualising psychopathology in any individual patient. Diagnosis should be part of a formulation that brings together aetiology, severity and functioning and should lead to a management plan