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A commentary on Kendler (2014)

A commentary on ‘Toward a limited realism for psychiatric nosology based on the coherence theory of truth’ by Kendler (2014)

Published online by Cambridge University Press:  09 October 2014

P. E. Bebbington
P. E. Bebbington*
Affiliation:
Division of Psychiatry UCL, Emeritus Professor of Psychiatry, 2nd Floor, Charles Bell House, 67-73 Riding House Street, London, UK
*
* Address for correspondence: P. Bebbington, Division of Psychiatry UCL, Emeritus Professor of Psychiatry, 2nd Floor, Charles Bell House, 67-73 Riding House Street, London, UK. (Email: rejupbe@ucl.ac.uk)
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Abstract

Kendler argues for the reality of psychiatric diagnostic classes in terms of two realist theories of truth, coherence and correspondence. I would advocate an alternative interpretation of the truth status of diagnostic classifications that leads to different conclusions. This is based firstly on Karl Popper's ideas on the growth of knowledge, whereby hypotheses developed from theoretical conjectures are deliberately subjected to attempts at refutation (we refine our always provisional views of what is true by increasing our knowledge of what is false). My second source of argument is John Wing's view that diseases are theoretical constructs on which disease theories may be based and tested. Such theories relate variously to aetiology, pathology, treatment, course and outcome. Rejecting a disease theory does not force rejection of the disease construct it seeks to qualify. We adhere to disease constructs more strongly than to the disease theories based on them. However, if it becomes apparent that the information obtained by testing disease theories is incoherent, we may eventually jettison particular disease constructs, as has happened regularly in the history of medicine. The disease constructs used in psychiatry may be approaching this point.

Keywords

Disease constructsdisease theoriesrefutationsyndromes
Type
Commentary
Information
Psychological Medicine , Volume 45 , Issue 6 , April 2015 , pp. 1119 - 1120
Copyright
Copyright © Cambridge University Press 2014 

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References

Bebbington, PE (2011). John Wing and the perils of nosolatry. Social Psychiatry and Psychiatric Epidemiology 46, 443–446.Google Scholar
Kendler, KS (2014). Toward a limited realism for psychiatric nosology based on the coherence theory of truth [Editorial]. Psychological Medicine. Published online: 2 September 2014 . doi:10.1017/S0033291714002177.Google Scholar
Popper, KR (1963). Truth, rationality, and the growth of scientific knowledge. In Conjectures and Refutations: The Growth of Scientific Knowledge (ed. Popper, K. R.), pp. 215–250. Routledge and Kegan Paul: London.Google Scholar