I know during DSM IV there was a growing school of thought that schizophrenia and bipolar weren’t valid diagnoses. Not only is there is too much overlap in the diagnostic criteria so two different clinicians could easily diagnose the same case with either illness, there are too many criterion for each diagnosis so you could end up with two people having the same diagnosis despite not sharing a single symptom.
I understand in DSM V schizophrenia has been broken down into a spectrum of disorders, so maybe the diagnoses are now more specific, consistent and valid. I don’t know as I’ve not looked so much at that edition, nor research which guided the updated definitions. What I do recall was a research basis suggesting many cases of bipolar and schizophrenia actually better fit a diagnosis of child ptsd and respond better to interventions designed around that. But of course mental health, and the causes of issues is complicated and poorly understood.
A lot of what the DSM does is group people by patterns of symptoms with medications which seem effective at addressing those symptoms (but maybe not the underlying causes). It isn’t really so good at understanding underlining causes of mental health in detail, or the importance of the individual’s situation and past.
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