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Comment by flashback2199 | Hacker News Reader

That industry should be taken with a grain of salt, IMHO, because I'm pretty sure you can diagnose literally every person on Earth with _something_ in the DSM.

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On paper, in that every person exhibits some symptoms of some disorders to some degree? Yea, anyone will tick some of those boxes.

But are those symptoms long-lasting? Are they severe? Do they impede day-to-day life? Professional diagnosis isn’t like WebMD.

Yes, exactly. Those questions are determined by interactions between the patient and the provider, which is inherently subjective and therefore flawed.

Exactly, people forget that the critical criteria for diagnosis is whether the cognitive features prevent the individual from achieving his personal goals in life, or cause problems from those around him. And indeed, as the article says, schizoid individuals have significantly reduced quality of life and some of the lowest scores of life success among personality disorders. Without this, there would be no basis for diagnosis.

Maybe some "disorders" in the DSM should just be considered personality types.

You'll be surprised what seemingly benign chemicals like calcium do to peoples personality's. I call hard water and strong black tea, liquid cocaine!

Not a great argument - I'm pretty sure you can diagnose literally every person on Earth with _something_ in the ICD (International Classification of Diseases) as well (kind of cheating because mental health stuff is in there too, but still, even if you exclude that section).

You can diagnose someone with 20/20 vision and no sign of any eye problems with an eye disease? Do tell :)

The ICD isn't limited to eye diseases.

More seriously, I think you need to restrict your argument to a subset of medicine, otherwise your argument is actually just "there are other area(s) of medicine that also exhibit the same issue" which is not really a counterpoint to my original comment but instead an addition to it.

So we can discount psychology as a whole but need to pick and choose medicine? Why don't we consider the various areas of psychology as well instead of just throwing out the whole book?

I'm not sure, I just don't think that a textbook that can be used to diagnose everybody with a disease is very trustworthy. Kind of like how passing a law that can be used to arrest anybody is generally not a good idea, or something like that.

Which brings us back to my inital point - the ICD can be used to do the same thing, therefore medicine isn't very trustworthy.

I would be curious to know what percentage of the diseases in the DSM vs the ICD are based on empirical tests. Questionnaires are not empirical.

I don't think either of us know that, but I makes sense to start asking increasingly hard to answer question while you're pushing the goalpost around.

My original comment in this thread was how anyone could be diagnosed with something in the DSM, and usage of subjective methods is a major way that can happen, so it seems the goalpost didn't move at all.

Why would that be a reason not to trust this field? I could understand this argument more if you were talking about a specific disorder being diagnosable in every person on earth--because how is that a disorder if it's the norm?--but you're very much not saying that.

As an example, would you consider dentistry untrustworthy as a whole just because dentists would diagnose almost every person with a cavity or some form of tooth or gum damage at some point in their lives?

So, something there, but the methodologies and understanding can be lackluster?

Yes, that's a good way to put it

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