Cough disorder: an allegory on DSM-IV

The DSM-IV is more a reliable descriptive nomenclature than a valid classification of diseases

The Diagnostic and statistical manual of mental disorders, third edition (DSM-III), published by the American Psychiatric Association in 1980, sought to define psychiatric syndromes in a way that increased the reliability of psychiatric terminology and diagnoses between practitioners and nations. The DSM-III’s introduction cautioned that, with regard to aetiology, it was a “generally atheoretical” document. The subsequent edition, the DSM-IV, published in 1994, went further, and cautioned specifically against diagnoses being applied in a “cookbook” fashion. Despite these warnings, conversion of the description of psychiatric disorders to discrete disease entities has not only occurred but, I believe, has also become problematic. Here, I present an allegory of a boy with “cough disorder” to illustrate.