The classification of mental disorders improved greatly in the last decade of the 20th century and now provides a reliable operational tool. Both the ICD and DSM classifications have greatly facilitated practice, teaching and research by providing better delineation of ‘syndromes’ (i.e. clustering commonly seen symptoms together). The absence of aetiological information linked to brain physiology that could serve as the basis of independent definitional variables has limited understanding of mental illness and has been a stumbling block to the development of better classifications. The use of a universal classification for differing cultures has also raised concerns about a lack of sensitivity to local diversity, especially as human behaviour is not always context free. Given these limitations and the expectations of scientific advances in the field of genetics, neurobiology and cultural studies, we should be able to build better classifications based on an international consensus informed by evidence-based research.

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