The first step to good treatment is acurate diagnosis. It stands to reason to group by symptoms could support diagnosis as a roadmap. It narrows down what needs

The first step to good treatment is acurate diagnosis. It stands to reason to group by symptoms could support diagnosis as a roadmap. It narrows down what needs to be considered and it ensures relevant possibilities are not overlooked. If ones interest is in research and understanding underlying causes some of the symptomatic categories are not helpful. People pushing the boundaries of knowledge have to structure these domains and will come up with new terminology. This terminology will not easily map to the symptomatic view. The rest of medicine may look like being interested in root causes. And where there is easy and accurate tests available that is true. There are areas in medicine where knowledge is limited and treatment is symptom focused. AMA's approach is middle age - but our knowledge is on middle age level compared to what we know e.g. how muscles work. In psychiatry there is a huge gap and misdiagnosis is very common and does real damage. To compound the issue diagnosis is linked to insurance payments which considering the fuzziness of knowledge frankly scary. I don't think much progress comes from restructuring or optimizing existing categories and labels. What will have an impact if we got a sufficiently large set of more narrow conditions with reliable tests. Then the old system will be swept away. Until then it will be hit and miss and the best one can hope for is an educated counterpart who is keeping an open mind and is able to observe well.