Abstract

The first time that formally a definition of mental disorder was presented was in DSM-III. This resulted from a complex conceptual analysis carried out by Spitzer, chair of the committee on nomenclature and statistics. The criteria of harm (distress-disability) arise as main defining characteristics for mental illness, being added that "there is an inference" that there is a dysfunction. The distress-disability model was later developed by Wakefield. This author argued that in a medical or psychiatric disorder there had to be a dysfunctional component (value free) and another one of harm (value laden). In this article, we intend to review the emergence and evolution of the definition of mental disorder and the importance that the criteria of distress and disability always had in this definition. This happened until the advent of DSM-5 when these criteria came to play a secondary role.

Biographic note

Prof. Diogo Telles Correia is Head of the Departments for Psychiatry and Psychology and also Introduction to Medicine and Associate Professor with aggregation at the Faculty of Medicine at the University of Lisbon.

He is a medical doctor specialized in psychiatry and a graduate consultant in psychiatry at the Central Hospital Santa Maria in Lisbon. He is also in charge of 7 courses at the Faculty of Medicine of the University of Lisbon, including psychology, psychiatry, communication skills in medicine, philosophy of psychiatry, etc.

He is also head of the Liason psychiatry and Psychosomatics section at European Psychiatric Association and International Lead for Portugal of the Collaborating Centre for Values Based Practice – St. Catherine’s College Oxford.

His research interests are focused on liaison psychiatry, psychopathology, philosophy of psychiatry and psychotherapies. In his role as a trainer in communication, he is particularly interested in the role of values-based practice in diagnostic assessment.