Once again, you've provided an excellent analysis. I share your concerns regarding Kendler's approach. While it represents an advancement from the metaphysical perspective, it appears to be applicable only (partially) to disorders with a high genetic risk such as schizophrenia, bipolar disorder, ADHD, and autism, excluding others.
Even within the high-risk categories, I'm skeptical that the known genetic variables can account for the majority of cases falling under these diagnoses. From my perspective, the genetic risk doesn't necessarily validate these categories as brain diseases but rather suggests that many diagnosed patients within these categories have psychiatric conditions where genetic variables significantly contribute to the causation process.
I think that the conceptual synthesis that you make about mental disorders is very valuable, but I do think that the categories of schizophrenia, bipolar, ADHD and autism will lead to some medical, neurobiological discoveries explaining a % of the cases, not all of them, and that those discoveries will lead to new categories, instead of validating the current ones. Think of brain imaging: it only captures macroscopic patterns, whereas the microscopic complexity of the nervous system is amazing. On the other hand, the autopsy studies are limited in terms of sample size and many confounding variables
I don't think that we should think of our current phenotypes as the end of the clinical story; instead we need to advance the clinical research to explore more precise phenotypes
Once again, you've provided an excellent analysis. I share your concerns regarding Kendler's approach. While it represents an advancement from the metaphysical perspective, it appears to be applicable only (partially) to disorders with a high genetic risk such as schizophrenia, bipolar disorder, ADHD, and autism, excluding others.
Even within the high-risk categories, I'm skeptical that the known genetic variables can account for the majority of cases falling under these diagnoses. From my perspective, the genetic risk doesn't necessarily validate these categories as brain diseases but rather suggests that many diagnosed patients within these categories have psychiatric conditions where genetic variables significantly contribute to the causation process.
I think that the conceptual synthesis that you make about mental disorders is very valuable, but I do think that the categories of schizophrenia, bipolar, ADHD and autism will lead to some medical, neurobiological discoveries explaining a % of the cases, not all of them, and that those discoveries will lead to new categories, instead of validating the current ones. Think of brain imaging: it only captures macroscopic patterns, whereas the microscopic complexity of the nervous system is amazing. On the other hand, the autopsy studies are limited in terms of sample size and many confounding variables
I don't think that we should think of our current phenotypes as the end of the clinical story; instead we need to advance the clinical research to explore more precise phenotypes