To what do psychiatric diagnoses refer? A two-dimensional semantic analysis of diagnostic terms

https://doi.org/10.1016/j.shpsc.2015.10.001Get rights and content
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Highlights

  • Descriptive and causal theories of reference are evaluated regarding diagnoses.

  • A two-dimensional semantic framework analysis of diagnostic terms is proposed.

  • This resolves tension between the uses and definitions of psychiatric diagnoses.

Abstract

In somatic medicine, diagnostic terms often refer to the disease processes that are the causes of patients' symptoms. The language used in some clinical textbooks and health information resources suggests that this is also sometimes assumed to be the case with diagnoses in psychiatry. However, this seems to be in tension with the ways in which psychiatric diagnoses are defined in diagnostic manuals, according to which they refer solely to clusters of symptoms. This paper explores how theories of reference in the philosophy of language can help to resolve this tension. After the evaluation of descriptive and causal theories of reference, I put forward a conceptual framework based on two-dimensional semantics that allows the causal analysis of diagnostic terms in psychiatry, while taking seriously their descriptive definitions in diagnostic manuals. While the framework is presented as a solution to a problem regarding the semantics of psychiatric diagnoses, it can also accommodate the analysis of diagnostic terms in other medical disciplines.

Keywords

Diagnosis
Medicine
Psychiatry
Causal theory of reference
Two-dimensional semantics

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