Classification Systems of Mental Disorders: Where Did We Go Wrong?

Although the classification of mental disorders has a long tradition, many validity and reliability problems still exist. Despite the great effort that was put into developing the most recent versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and International Classification of Diseases (ICD-11), these revised versions of the traditional classification systems have not fully solved these problems. There are several critical aspects related to the development and structure of both diagnostic systems. Alternative approaches have been suggested, such as the Research Domain Criteria, but currently these options cannot be seen as a replacement and need to be developed further. Most support is found for an approach that would start de novo with a new system, primarily based on neurobiological parameters. For various reasons, however, such an approach also does not appear to be an ideal solution, given the gap between clinical phenomenology and neuroscience-related findings.