Chapter 4. Implications of Comorbidity for the Classification of Mental Disorders: The Need for a Psychobiology of Coherence

  1. Mario Maj2,
  2. Wolfgang Gaebel3,
  3. Juan José López-Ibor4 and
  4. Norman Sartorius5
  1. C. Robert Cloninger

Published Online: 24 APR 2002

DOI: 10.1002/047084647X.ch4

Psychiatric Diagnosis and Classification

Psychiatric Diagnosis and Classification

How to Cite

Cloninger, C. R. (2002) Implications of Comorbidity for the Classification of Mental Disorders: The Need for a Psychobiology of Coherence, in Psychiatric Diagnosis and Classification (eds M. Maj, W. Gaebel, J. J. López-Ibor and N. Sartorius), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/047084647X.ch4

Editor Information

  1. 2

    University of Naples, Italy

  2. 3

    University of Düsseldorf, Germany

  3. 4

    Complutense University of Madrid, Spain

  4. 5

    University of Geneva, Switzerland

Author Information

  1. Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 S. Euclid, St. Louis, Missouri 63110–1093, USA

Publication History

  1. Published Online: 24 APR 2002
  2. Published Print: 15 APR 2002

ISBN Information

Print ISBN: 9780471496816

Online ISBN: 9780470846476



  • diagnosis;
  • ICD;
  • DSM;
  • diagnostic systems;
  • comorbidity;
  • diagnostic criteria;
  • “atypical” clinical features;
  • classification;
  • structured interview schedules


The classification of mental disorders is currently based on a descriptive approach that attempts to be atheoretical. This descriptive approach is basically a refinement and extension of categorical diagnosis as advocated by Emil Kraepelin and others for schizophrenic and mood disorders. The current diagnostic approach in the International Classification of Diseases and in the American Psychiatric Association's Diagnostic and Statistical Manual was stimulated by the work of Robins and Guze on the establishment of diagnostic validity for mental disorders. Consequently, it is revealing to examine the initial assumptions that influenced the development of the current diagnostic systems, particularly in order to appreciate the implications of comorbidity for the classification of mental disorders.