LIMITATIONS OF THE SYMPTOM-ORIENTED APPROACH TO PSYCHIATRIC RESEARCH

Background We critically reviewed the arguments of the symptom-oriente d researchers who propose to replace syndromes and diagnostic categori es with symptoms as units of analysis in psychiatric research. Method Three central arguments were examined: (a) current diagnostic categori es lack reliability and validity; (b) using diagnostic categories lead s to misclassification and confounding; and (c) symptom - oriented the ories are clearer, easier to test, and more likely to lead to an expla nation of psychopathology. These arguments are based on three assumpti ons respectively: (a) symptoms have higher reliability and validity; ( b) underlying pathological processes are symptom-specific; and (c) elu cidation of the process of symptom development will lead to (and must precede) the discovery of the causes of syndromes. Results We found li ttle evidence supporting these assumptions and arguments based on them . Conclusion There are no clear advantages in replacing syndromes with symptoms as units of analysis for psychiatric research.