A Consideration of the State of the Art of Diagnosis in Real Clinical Settings

Summary

If diagnosis is to be of value to the clinician the classes must be both functional and different. An examination of diagnosis for 2824 Navy enlisted men who were hospitalized for psychiatric reasons was made. The results showed the following: (a) Diagnosis does reflect clinical decisions manifested by different dispositions for different major classes. (b) The classes were not defined by standard family histories, disciplinary and job histories, past medical histories, attitudes, or standard demographic information. (c) The categories do define distinct factors as used by psychiatry in one industrial setting—the Navy. (d) these results would lead to a Feighner et al. (4) conclusion that the nomenclature is meaningful and can function usefully in a setting in which real defined outcomes are being decided. (e) Studies arguing against the use of diagnostic nomenclature may have some points to make, but their results are limited. Perhaps many experimentally structured tests of the nomenclature have not attended to the dimensions of diagnosis functioning in clinical settings.