3 ms·

All models are wrong, but some are useful. This model has proven useful. These symptoms do cluster. Most people never ever experience halluzinations, but then

All models are wrong, but some are useful. This model has proven useful. These symptoms do cluster. Most people never ever experience halluzinations, but then they also experience delusions or other psychotic problems, relatively specific social problems, paranoia, etc. In some sense this is a human-readable equivalent of logistic regression. Because schizophrenia isn't as well understood as some other diseases, you can only make "exact" models about meaningless abstractions, or create fuzzy models which allow meaningful treatment decisions.

haberman 12y ago
All of this is exactly what I was meaning to say with my initial comment. Current models are fuzzy, but in the absence of better information they are the best we can do, and they are useful.
dragonwriter 12y ago
> All models are wrong, but some are useful. This model has proven useful. The model is clinically useful, but the assumption (which the DSM does not itself advertise or support, which is made implicitly when its categories are used as the basis for research) that the diagnostic categories in the DSM represent commonality in origin is an impediment to research. While many people have overstated the NIMH move away from DSM categories as a basis for research funding as something like an indictment of the DSM in its intended role or, even more hyperbolicly, a rejection of psychiatry as a field, it is an important move that recognize that the DSM categories' utility in their intended purpose does not imply that they represent real commonality.
- bayesianhorse 12y ago
  Yes, exactly this. DSM criteria do predict effective treatment, negative consequences for the patients (both with and without treatment), and help plan for the costs of these conditions. These factors are clinically relevant. Neuroscience tries to get a firmer grip on how the brain works, and what goes wrong when it doesn't. This research hardly touches the clinical practice as of yet, but ultimately diagnostics and treatment might improve largely.

haberman 12y ago

All of this is exactly what I was meaning to say with my initial comment. Current models are fuzzy, but in the absence of better information they are the best we can do, and they are useful.

dragonwriter 12y ago

> All models are wrong, but some are useful. This model has proven useful. The model is clinically useful, but the assumption (which the DSM does not itself advertise or support, which is made implicitly when its categories are used as the basis for research) that the diagnostic categories in the DSM represent commonality in origin is an impediment to research. While many people have overstated the NIMH move away from DSM categories as a basis for research funding as something like an indictment of the DSM in its intended role or, even more hyperbolicly, a rejection of psychiatry as a field, it is an important move that recognize that the DSM categories' utility in their intended purpose does not imply that they represent real commonality.

bayesianhorse 12y ago
Yes, exactly this. DSM criteria do predict effective treatment, negative consequences for the patients (both with and without treatment), and help plan for the costs of these conditions. These factors are clinically relevant. Neuroscience tries to get a firmer grip on how the brain works, and what goes wrong when it doesn't. This research hardly touches the clinical practice as of yet, but ultimately diagnostics and treatment might improve largely.