Readers of this blog should be interested in a recent entry in the Stanford Encyclopedia of Philosophy (SEP) on the "concepts of disease and health." It is written by Dominic Murphy, author of a very important book, Psychiatry in the Scientific Image (2006). The latter offers a "qualified defense of the medical model, which says psychiatry is a branch of medicine dedicated to uncovering the neurological basis of disease entities." In other words, for Murphy, psychiatry is best understood as "clinical cognitive neuroscience."
As things stand today, Murphy explains, psychiatry relies on four criteria to validate a diagnosis: natural history (of a syndrome: its characteristic clinical course and outcome); family history (including genetics); differential response to treatment; and laboratory findings. The problem with these criteria, notes Murphy, as emblematically enshrined in the DSM, is a failure to give pride of place to "causal information," apart from the lack of explicit reference to requisite normative considerations (e.g., a model of rationality). We are left, in other words, with the picture of valid syndrome on the order of a "collection of symptoms that cluster together" but without the kind of information essential to a medical (or biological) model of psychiatric disease/disorder. Put differently, "The concepts of clinical phenomenology are notoriously vague, imprecise, unquantified. By limiting the data gathered in diagnosis to the salient and easily identifiable signs and symptoms of clinical phenomenology, the DSM-IV-TR [fourth ed., revised text] scheme ignores a wide range of other data about mental functioning that can be gathered by psychometric techniques and by methods used in cognitive science and neuroscience."