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‘Wrong-headed nosology’

Vol. 5, No. 5 / May 2006

Interepisode phenomenology of bipolar disorder and schizophrenia are qualitatively different (Current Psychiatry, March 2006). Printing Drs. Lake and Hurwitz’ wrong-headed nosology disserves patients because impressionable residents and students reading about it might take it as truth and adopt it unexamined.

I also fear that the authors have been swayed by the idea that DSM-IV-TR is necessarily valid. DSM-IV ensures that all disorders are called by the same names but may or may not represent valid conceptions of mental life and its disorders.

I do agree in part with rejecting the notion of “schizoaffective disorder,” as the term is grossly overused. I think “schizoaffective” is often an easy shorthand for “bad mental illness” and is too frequently used without considering the psychopathologic phenomenology evident over the course of the patient’s life.

Mark Mollenhauer, MD
Mental Illness—Substance Abuse Program
Johns Hopkins Bayview Medical Center, Baltimore, MD

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