Psychiatric Diagnosis Revisited

This book explores the purpose of clinical psychological and psychiatric diagnosis, and provides a persuasive case for moving away from the traditional practice of psychiatric classification. It discusses the validity and reliability of classification-based approaches to clinical diagnosis, and frames them in their broader historical and societal context. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is used across the world in research and a range of mental health settings; here, Stijn Vanheule argues that the diagnostic reliability of the DSM is overrated, built on a limited biomedical approach to mental disorders that neglects context, and ultimately breeds stigma. The book subsequently makes a passionate plea for a more detailed approach to the study of mental suffering by means of case formulation. Starting from literature on qualitative research the author makes clear how  to guarantee the quality of clinical case formulations. 

“Rooted in the history of critiques of the DSM while also touching on current issues and approaches to diagnosis, Psychiatric Diagnosis Revisited’s push to move beyond mere classification as the final outcome of the diagnostic process and to enrich diagnosis with case formulation will resonate with anyone who has wrestled with the inadequacies the current DSM-based diagnostic system.” (Sarah Karalunas, Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 57 (3), March, 2018)

“The latest publication … provides an alternative diagnostic approach for clinicians working in the ‘psy-disciplines’ via clinical case formulation. … a thought provoking book relevant to a broad range of theorists, academic and clinicians interested in both the scientific / epistemological status of DSM and to clinical practice. … Vanheule’s book makes the case for an evidence based practice where more time – for both direct clinical contact and case formulation practice – is a necessary condition for best clinical practice.” (Alessandro Musetti, Frontiers in Psychology, journal.frontiersin.org, June, 2017)

“This book … is rigorously developed, authentic and open, and balanced in terms of taking the contextual perspective of the other as starting point. The case formulation approach is particularly suitable in the area of psychosis … counterbalancing the toxic effects of the schizophrenia diagnosis and the meaning of devastating brain disease that has become associated with it. I would recommend it to all looking for a respectful and informative way to describe mental distress in the context of psychosis.” (Jim van Os, Psychosis, Vol. 19 (2), May, 2017)

Stijn Vanheule is a clinical psychologist and a professor at Ghent University, Belgium. He is also a privately practicing psychoanalyst and a member of the New Lacanian School for Psychoanalysis. He is the author of The Subject of Psychosis: A Lacanian Perspective and Diagnosis and the DSM – A Critical Review.