Samuel Guze

We kind of build on Dr. Feinstein's thesis and related in turn to the work of Robbins and Gouzet, as Mark mentioned, and their criteria for validity.

And just to refresh folks memory, Eli Robbins and Sam Guze came up with five criteria for establishing the validity of a disease or disorder.

Sometimes these are called phases with the implication that as we learn more and more about a condition, we move from phase one to phase two, right up to phase five.

So what are these? First of all, a clinical description of the condition.

In fact, The original goal after the publication of DSM-III was to subject the new categories to rigorous validity testing in line with what Robbins and Gouzet proposed in their seminal paper in 1970.

We're basically arguing that we need to do that, that we still need to take validity into account, and that, you know, these categories ought to be studied.

You know, Sam Guze, in one of his early papers in the 1960s, talked about tough-mindedness in psychopathology, that we need to be tough-minded, that we can't just accept the status quo and say, well, you know, we're doing the best we can.

And we actually have to think really hard about this stuff.

Um, uh, it's, it's good.

Goodwin and Guze's psychiatric diagnosis.

Uh, um, the, the last edition that was written by Goodwin and Guze, I think was published in the earlier mid-1990s, they died.

And the new authors of that textbook, I think it retains the name Goodwin and Gouzet, but they have expanded it.

But Goodwin and Gouzet's fourth edition of Psychiatric Diagnosis lists 12 according to them, valid psychiatric conditions.

Uh, and so there, there's an entire movement led mostly by researchers, um, who want quantitative uh figures to study empirically away from classic medical thinking in psychiatry um and um and this is this is like a really important um uh you know because you know one of the things you hear so often is that um you know for instance the classic uh kreplinian dichotomy Dementia praecox and manic depressive insanity, which is more or less the difference between schizophrenia and bipolar disorder.

It's not exactly the same, but more or less, right? So people will say, oh, they share a lot of their genetics and they share a lot of their symptoms.

Are they really two different diseases? Robinson-Guzet would say, well, they share a third of associated genes.

In about five minutes, I'm going to tell you about the small group of researchers in St. Louis who changed American mental health forever.

You have probably never heard their names.

Most therapists hadn't.

I hadn't heard their names until I started investigating this.

And you are not going to look at the idea of diagnosing, the idea of doing this paperwork for the insurance panels, the DSM codes and diagnosis, ICD.

You're never going to look at these things the same way again.