Foundations for a realist ontology of mental disease.

Werner Ceusters,Barry Smith

doi:10.1186/2041-1480-1-10

Werner Ceusters, Barry Smith

Open Access

https://doi.org/10.1186/2041-1480-1-10

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Abstract

While classifications of mental disorders have existed for over one hundred years, it still remains unspecified what terms such as 'mental disorder', 'disease' and 'illness' might actually denote. While ontologies have been called in aid to address this shortfall since the GALEN project of the early 1990s, most attempts thus far have sought to provide a formal description of the structure of some pre-existing terminology or classification, rather than of the corresponding structures and processes on the side of the patient.We here present a view of mental disease that is based on ontological realism and which follows the principles embodied in Basic Formal Ontology (BFO) and in the application of BFO in the Ontology of General Medical Science (OGMS). We analyzed statements about what counts as a mental disease provided (1) in the research agenda for the DSM-V, and (2) in Pies' model. The results were used to assess whether the representational units of BFO and OGMS were adequate as foundations for a formal representation of the entities in reality that these statements attempt to describe. We then analyzed the representational units specific to mental disease and provided corresponding definitions.Our key contributions lie in the identification of confusions and conflations in the existing terminology of mental disease and in providing what we believe is a framework for the sort of clear and unambiguous reference to entities on the side of the patient that is needed in order to avoid these confusions in the future.

Highlights

The Classification of Diseases There is a long history of attempts to categorize what are commonly referred to as ‘diseases’, ‘disorders’ or ‘illnesses’
An exception is the Open Biomedical Ontologies (OBO) Foundry [11] initiative, which accepts under its label only those ontologies that adhere to the principles of ontological realism [12]
I.e. computer science, view of ontology is focused on the logical consistency and inferential implications of ontologies as sets of assertions, the view of the OBO Foundry is that the quality of an ontology is - primarily - determined by the accuracy with which it represents the preexisting structure of reality [13]

Summary

Introduction

The Classification of Diseases There is a long history of attempts to categorize what are commonly referred to as ‘diseases’, ‘disorders’ or ‘illnesses’. I.e. computer science, view of ontology is focused on the logical consistency and inferential implications of ontologies as sets of assertions, the view of the OBO Foundry is that the quality of an ontology is - primarily - determined by the accuracy with which it represents the preexisting structure of reality [13] Ontologies, from this perspective, are representational artifacts, comprising a taxonomy as their central backbone, whose representational units are intended to designate universals (such as human being and patient role) or classes defined in terms of universals (such as patient, a class encompassing human beings in which there inheres a patient role) and certain relations between them [14]. Depending on whether the representational units designate correctly, the following distinctions are made:

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