The Vote on DSM-IV-Reply

In Reply.— We also are in favor of motherhood, family, and an empirically based classification of disease. However, we do not agree with our colleague, Dr Taylor, about what has been accomplished by the development ofDSM-IIIandDSM-III-Rand, more importantly, what steps should be taken to develop a significantly betterDSM-IV.Dissatisfaction With the Conceptual Framework ofDSM-IIIandDSM-IIIR.—No one, including us, is entirely happy with our current nosologic system. Although Dr Taylor denigrates the little progress that has been made since Kraepelin, it is significant that he offers no alternative system or conceptual framework to replace the largely descriptive classification that is embodied inDSM-IIIandDSM-IIIR. The problem of an imperfect classification is not unique to psychiatry: Feinstein,1a noted medical nosologist, has recently discussed the sad scientific status of the classification of clinical medicine as embodied in theInternational Classification of Diseases. His most