Validating concepts of mental disorder: precedents from the history of science

A fundamental issue in any branch of the natural sciences is validating the basic concepts for use in that branch. In psychiatry, this issue has not yet been resolved, and indeed, the proper nature of the problem has scarcely been recognised. As a result, psychiatry (or at least those parts of the discipline which aspire to scientific status) still cannot claim to be a part of scientific medicine, or to be incorporated within the common language of the natural sciences. While this creates difficulties within the discipline, and its standing in relation to other branches of medicine, it makes it an exciting place for “frontiersmen” (and women). This is one of the key growing points in the natural science tradition. In this essay, which moves from the early history of that tradition to today’s debates in scientific psychiatry, I give my views about how these fundamental issues can move towards resolution.

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