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Food for Thought for Epidemiologists

R. E. Kendell, MD

Arch Gen Psychiatry. 1988;45(4):374-376.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The title of Vaillant and Schnurr's¹ article in this issue of the Archives highlights the most important problem that has confronted psychiatric epidemiology for much of the past decade. We have learned how to make reliable diagnoses, but we still have no adequate criterion of their validity, and the achievement focuses attention on the failure. We draw the boundaries between one syndrome and another, and between illness and normality, in widely differing places and using a variety of different criteria and we have no adequate means of deciding which is right, or even which is preferable for a given purpose. The main reasons for this state of affairs are now well understood. Our ignorance of etiology forces us to define most disorders by their symptoms, and syndromes merge insensibly into one another, and into "normal distress," with no obvious natural boundaries or "points of rarity" to separate them. Many . . . [Full Text PDF of this Article]

Author Affiliations
From the University of Edinburgh Department of Psychiatry, Royal Edinburgh Hospital.

Footnotes
Accepted for publication Sept 10, 1987.

Reprints not available.

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