In this article we argue that mental disorders have come to be defined according to a descriptive theory of meaning. In other words, mental disorders are defined according to superficial descriptive criteria that count as necessary and sufficient criteria for the inclusion of a particular instance under its corresponding class. These descriptive criteria are allegedly theory independent, leading to the assumption that psychiatric symptoms are directly identified in an object-like fashion. Against this view, we hold that a descriptive theory of meaning is unable to offer a proper account of the meaning of mental disorders both due to its own internal limitations and to the specific nature of psychiatric phenomena. Due to the hermeneutic structure of psychiatric practice, we argue that the identification and description of mental symptoms and disorders unavoidably depends on (frequently unacknowledged) theoretical assumptions. Since there is no global consensus regarding these theoretical commitments, and due to the fact that these significantly affect the final picture we hold with respect to each mental disorder, we believe that these commitments should be explicitly stated both in diagnostic argumentation and in theoretical discussions in order to maximise self- and mutual understanding.

Machado A, Lourenço O, Silva FJ: Facts, concepts and theories: the shape of psychology's epistemic triangle. Behav Philos 2000;28:1-40.
Hempel C: Fundamentals of taxonomy; in Sadler JZ, Wiggins OP, Schwartz MA (eds): Philosophical Perspectives on Psychiatric Diagnostic Classification. Baltimore, Johns Hopkins University Press, 1994.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4. Arlington, American Psychiatric, 2000.
World Health Organisation: The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva, World Health Organization, 1993.
Malmgren H: Psychiatric classification and empiricist theories of meaning. Acta Psychiatr Scand Suppl 1993;373:48-64.
Jablensky A, Kendell RE: Criteria for assessing a classification in psychiatry; in Maj M, Gaebel W, Lopez Ibor JJ, Sartorius N (eds): Psychiatric Diagnosis and Classification. New York, Wiley, 2002.
Patil T, Giordano J: On the ontological assumptions of the medical model of psychiatry: philosophical considerations and pragmatic tasks. Philos Ethics Humanit Med 2010;5:3.
Robins E, Guze SB: Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. Am J Psychiatry 1970;126:983-987.
Klerman GL: The evolution of a scientific nosology; in Shershow JC (ed): Schizophrenia: Science and Practice. Cambridge, Harvard University Press, 1978.
Zachar P, Kendler KS: Psychiatric disorders: a conceptual taxonomy. Am J Psychiatry 2007;164:557-565.
Malmgren H, Lindqvist G: The semantic status of diagnostic criteria for organic mentla syndromes and disorders in DSM-III and DSM-III-R. Acta Psychiatr Scand 1993;373:33-47.
Bayle ALJ: De la cause organique de l'aliénation mentale accompagnée de paralysie générale. Annales Médico-Psychologiques 1855;1:409-425.
Rafalovich A: Framing ADHD Children. Plymouth, Lexington Books, 2004.
Frege G: On sense and reference; in Geach P, Black M (eds): Translations from the Philosophical Writings of Gottlob Frege. Blackwell, Hoboken, 1960.
Russell B: On denoting; in Marsh R (ed): Logic and Knowledge. New York, Macmillan, 1956.
Fernández-Moreno L: La Referencia de los Nombres Propios. Madrid, Trotta, 2006.
Dupré J: Natural kinds and biological taxa. Philosophic Rev 1981;90:66-91.
Zachar P: Psychiatric disorders are not natural kinds. Philos Psychiatry Psychol 2000;7:167-182.
Recanati F: El Significado Literal. Madrid, A Machado Libros, 2006.
Searle J: The background of meaning; in Searle J, Kiefer F, Bierwisch M (eds): Speech Acts Theory and Pragmatics. Dordrecht, Reidel, 1980.
Recanati F: Contextualism and anti-contextualism in the philosophy of language (accessed August 18, 2012).
Wittgenstein L: Philosophical Investigations. London, Basil Blackwell, 1989.
Devitt M: Theories of reference; in Nagel L (ed): Encyclopaedia of Cognitive Science. London, Nature Publishing Group, 2003.
Rejón C: La cortedad del decir. El diagnóstico psiquiátrico como fijación de referentes empíricos (accessed February 8, 2013).
Kripke SA: Naming and Necessity. Cambridge, Harvard University Press, 1980.
Putnam H: The meaning of meaning; in Putnam H (ed): Mind, Language and Reality (Philosophical Papers, vol 2). Cambridge, Cambridge University Press, 1975.
Devitt M: The case for referential descriptions; in Reimer M, Bezuidenhout A (eds): Descriptions and Beyond. Oxford, Oxford University Press, 2004.
Bleuler E: Dementia Praecox oder Gruppe der Schizophrenien; in Aschaffenburg G (ed): Handbuch der Psychiatrie. Leipzig, Deuticke, 1911.
Minkowski E: La Schizophrénie: Psychopathologie des Schizoïdes et des Schizophrènes. Paris, Payot, 1927.
Blankenburg W: Der Verlust der Natürlichen Selbstverständlichkeit: ein Beitrag zur Psychopathologie Symptomarmer Schizophrenien. Berlin, Enke, 1971.
Stanghellini G: Disembodied Spirits and Deanimated Bodies: the Psychopathology of Common Sense. New York, Oxford University Press, 2004.
Sass LA, Parnas J: Schizophrenia, consciousness and the self. Schizophr Bull 2003;29:427-444.
Cooper R: Psychiatry and the Philosophy of Science. Stocksfield, Acumen, 2007.
Griesinger W: Mental Pathology and Therapeutics. London, New Sydenham Society, 1867.
Hemsley DR, Garety PA: The formation of maintenance of delusions: a Bayesian analysis. Br J Psychiatry 1986;149:51-56.
Frith CD, Corcoran R: Exploring ‘theory of mind' in people with schizophrenia. Psychol Med 1996;26:521-530.
Laing R: The Divided Self: An Existential Study in Sanity and Madness. London, Penguin, 2010.
Kraus A: Schizophrenic Delusion and Hallucination as the Expression and Consequence of an Alteration of the Existential a prioris: Reconceiving Schizophrenia. New York, Oxford University Press, 2007, pp 97-112.
Lovett BJ, Hood BS: Realism and operationism in psychiatric diagnosis. Philosophic Psychol 2011;24:207-222.
Fulford B, Tim T, George G: Oxford Textbook of Philosophy and Psychiatry. Oxford, Oxford University Press, 2006.
Quine WV: Main trends in recent philosophy: Two Dogmas of Empiricism. Philosophic Rev 1951;60:20-43.
Putnam H: Reason, Truth and History (accessed August 18, 2012).
Hesse M: Revolutions and Reconstructions in the Philosophy of Science. Brighton, Harvester, 1980.
Hanson NR: Patterns of Discovery. Cambridge, Cambridge University Press, 1958.
Kuhn TS: The Structure of Scientific Revolutions, ed 3. Chicago, University of Chicago Press, 1996.
Spitzer M: On defining delusions. Compr Psychiatry 1990;31:377-397.
Parnas J, Bovet P: Research in psychopathology: epistemologic issues. Compr Psychiatry 1995;36:167-181.
Faust D, Miner RA: The empiricist and his new clothes: DSM-III in perspective. Am J Psychiatry 1986;143:962-967.
Esquirol É: Des maladies mentales: considérées sous les rapports médical, hygiénique, et médico-légal. Bruxelles, Tircher, 1838.
Jaspers K: The phenomenological approach in psychopathology. Br J Psychiatry 1968;114:1313-1323.
Walker C: Karl Jaspers as a Kantian psychopathologist. I. The philosophical origins of the concept of form and content. Hist Psychiatry 1993;4:209-238.
Schneider K: ¿Qué se entiende hoy por Esquizofrenia?; in López Ibor J (ed): Symposium Sobre Esquizofrenia. Madrid, Consejo Superior de Investigaciones Científicas, Departamento de Medicina Psicosomática, 1957, pp 30-42.
Chung MC, Graham G: Reconceiving Schizophrenia. Oxford, Oxford University Press, 2007.
Rejon C: Logic structure of clinical judgment and its relation to medical and psychiatric semiology. Psychopathology 2012;45:344-351.
Ramos Gorostiza P, Adán Manes J: Misunderstanding psychopathology as medical semiology: an epistemological enquiry. Psychopathology 2011;44:205-215.
Rodrigues AC, Banzato CE: Construct representation and definitions in psychopathlogy: the case of delusion. Philos Ethics Humanit Med 2010;5:5.
Ramos Gorostiza P, Rejón Altable C: El Esquema de lo Concreto: una Introducción a la Psicopatología. Madrid, Triacastela, 2002.
Gordon AM: The biochemistry of depression. J Int Med Res 1977;5(suppl 4):81-84.
Beck AT, Rush AJ, Shaw BF, Emery G: Cognitive Therapy of Depression. New York, Guilford Press, 1987.
Tellenbach H: Melancholie: Problemgeschichte, Endogenität, Typologie, Pathogenese, Klinik. Berlin, Springer, 1961.
Berrios GE, Chen EY: Recognising psychiatric symptoms: relevance to the diagnostic process. Br J Psychiatry 1993;163:308-314.
Longino H: Science as Social Knowledge. Princeton, Princeton University Press, 1990.
Thornton T: Tacit knowledge as the unifying factor in evidence based medicine and clinical judgement. Philos Ethics Humanit Med 2006;1:2.
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