Brief comments from a psychiatric nosologist weary from his own attempts to define mental disorder: Why Ossorio's definition muddles and Wakefield's "harmful dysfunction" illuminates the issues.

Abstract

The author provides a personal history of efforts to define mental disorder in the various editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. Weary from his own efforts, as a psychiatric nosologist, to define “mental disorder,” and unsure about the importance of having a consensus definition (there is none for medical disorder), the author regards Wakefield's “harmful dysfunction” construct as a brilliant breakthrough. Wake-field's definition clarifies the underlying issues while the author believes that Ossario's definition muddles the issues.