A critical engagement with the DSM-5 and psychiatric diagnosis

Abstract

Classifications in psychiatry can result in the reification of hypothetical approaches, arbitrary categorisation and social injustice. This article applies a social constructivist approach to critique the DSM-5 as a neurobiological model of psychiatric diagnosis which ignores psychosocial factors such as poverty, unemployment and trauma as causes of mental distress. It challenges the universality of psychiatric diagnosis and proposes that cultural psychiatry’s framing of ‘culturebound syndromes,’ or ‘cultural case formulation’ guidelines, is oversimplified. Use of the DSM in the South African context risks perpetuating injustice by labelling and stigmatising people who have in the past been racially stigmatised by apartheid. In culturally diverse South Africa, psychiatric diagnosis should take into account alternative explanatory models that provide a more balanced view of the complex and dynamic relationship between biological and sociocultural forces in the manifestation of psychopathology.