The Differences Between Syndrome, Disorder and Disease

Your doctor says “syndrome.” The internet says “disorder.” A relative insists it’s “a disease, plain and simple.” You leave the appointment holding a printout and a growing suspicion that these three words are being tossed around like interchangeable salt shakers. They aren’t, quite. But they aren’t cleanly separate either, and anyone who tells you the boundaries are tidy hasn’t read much medical history.

Here’s the short version. A syndrome is a recognizable cluster of signs and symptoms that tend to occur together. A disorder is a pattern of disrupted function that causes distress or impairment. A disease usually points to a specific underlying pathology, often with an identified cause. The differences matter for diagnosis, treatment, insurance paperwork, and, perhaps more than people admit, how patients feel about themselves.

The trouble starts when we ask where one word ends and another begins, since medicine itself doesn’t use them consistently.

Consider that AIDS is called a syndrome, depression a disorder, and Alzheimer’s a disease, though each could be argued the other way.

This article untangles the differences between syndrome, disorder, and disease: what each term means, how physicians and psychiatrists use them, why the lines blur, and what the labels do to real people.

What is the difference between a syndrome, a disorder, and a disease?

Think of a ladder of certainty. At the bottom sits the syndrome: a set of symptoms and signs that reliably show up together, whether or not anyone knows why. In the middle sits the disorder: a recognized pattern of disrupted functioning, often defined by symptoms and impairment rather than lab tests. At the top sits the disease: a condition with an identified biological cause or pathology.

That ladder is a useful simplification, not a law. One medical encyclopedia entry on the topic describes a syndrome as a constellation of signs and symptoms that occur together and covary over time, a disorder as a collection of signs and symptoms with associated features presumed to be related, and a disease as an involuntary physiological or biological illness that typically has some underlying cause.

Look at the table twice and you’ll notice the soft edges. Down syndrome has a well-known cause (an extra copy of chromosome 21), and yet we still say “syndrome.” Alzheimer’s disease has a name that sounds definitive, while researchers still argue about what triggers it. Naming conventions often reflect history, not logic.

A few practical rules of thumb survive the exceptions:

• If the label stresses a pattern of symptoms, you’re probably hearing a syndrome.
• If it stresses impaired functioning in daily life, it’s likely a disorder.
• If it points to a mechanism such as an infection, a tumor, or a damaged organ, it’s usually a disease.

And here’s the catch. These words can describe the same condition at different stages of knowledge. A mystery cluster of symptoms becomes a syndrome, then a disorder as researchers refine it, and sometimes a disease once someone finds the cause. Language trails discovery.

So when a clinician picks one word over another, what you’re often hearing is how much is known, not how serious it is.

What exactly is a syndrome?

Take Rosa (an illustrative composite), a woman in her forties whose doctor notes high blood pressure, a larger waistline, elevated blood sugar, high triglycerides, and low HDL cholesterol. None of these findings is a single “disease” in itself. Together, though, they raise the risk of heart disease and diabetes, so her doctor names the cluster: metabolic syndrome. The word does a job. It tells everyone, at a glance, that these things travel together.

A syndrome, in plain terms, is a recognizable pattern of signs (what a clinician observes) and symptoms (what a patient reports) that occur together often enough to merit a name. The pattern may have one cause, several causes, or causes nobody has pinned down yet. A medical knowledge-base article defines it as a recognizable complex of symptoms and physical findings indicating a specific condition whose direct cause isn’t necessarily understood.

The word itself comes from the Greek for “running together.” Its history is a bit of a mess. A historical review in the medical literature noted that the term fell in and out of favor, was redefined in the early twentieth century as a set of causally related symptoms, and was later refined as a cluster occurring together, sometimes by coincidence. Many writers, the review observed, use it loosely for any abnormal condition when no better designation exists.

Physician John Langdon Down gave his name to one of the most famous examples. In 1866 he published a description of features he’d observed in some patients, work that later led to the label Down syndrome. His accompanying racial theory of classification was wrong and offensive, and it has long since been discarded. The condition itself was explained nearly a century later, in 1959, when researchers identified an extra chromosome 21 (trisomy 21). The name stuck even after the cause was known.

That detail answers a common question. Why isn’t Down syndrome called a disease? Because it isn’t an illness that comes and goes, it isn’t contagious, and it isn’t something that’s “caught.” It’s a genetic condition with a wide spectrum of features, and calling it a disease would misdescribe it.

Other syndromes include Tourette syndrome (tics and vocalizations), irritable bowel syndrome (recurrent abdominal pain with altered bowel habits), polycystic ovary syndrome, and chronic fatigue syndrome. Some of these have clearer biology than others, and some remain defined mostly by their symptom pattern.

The strength of the word “syndrome” is that it’s honest about uncertainty. It says: this pattern is real, we’ve seen it, and we’re still working on the “why.”

Its weakness? People hear it and assume it means “vague,” which it doesn’t.

What makes something a disease?

A disease is a condition in which the body or mind departs from normal biological functioning in a way that can usually be traced to an underlying process, such as infection, genetic abnormality, injury, tumor growth, or immune malfunction. When someone says “disease,” they typically imply cause, pathology, and a recognizable course.

Philosophers of medicine have spent decades arguing about this. The best-known naturalist account comes from Christopher Boorse, whose biostatistical theory holds that disease is a state of statistically species-subnormal biological functional ability, relative to age and sex. In his view, health is normal functioning, defined statistically, and disease is a deviation from the species’ natural design. Crucially, Boorse insists that this is a matter of biology, not values: whether something counts as a disease is a scientific question, not an opinion.

It’s an elegant idea with obvious uses. A kidney that filters well below the typical level for a person’s age and sex is diseased, whatever anyone feels about it. A heart valve that fails to close properly counts. Plenty of clinicians quietly think this way.

The theory has critics, and their points are fair. Some deviations from “typical” function are harmless (a rare, benign variation, for instance), while some conditions we call diseases might be common in older age and thus “statistically normal” for that group. Others argue that medicine is unavoidably value-laden: we call something a disease partly because it’s bad for the person.

Think about Marcus (an illustrative composite), who learns he has the sickle cell trait. He carries one copy of the gene variant, has no symptoms, and lives a normal life. Does he have a disease? Most clinicians would say no: he carries a genetic variant that doesn’t impair his functioning. His cousin, with two copies, has sickle cell disease. Same gene, different status.

What usually earns the word “disease” in practice is a combination of features:

• An identifiable biological mechanism or pathology.
• A characteristic pattern of symptoms and a predictable course.
• Objective findings, such as lab results, imaging, or biopsy.
• A treatment that targets the underlying process, not only the symptoms.

Even so, exceptions abound. Hypertension is called a disease on the basis of a number, not symptoms. Many people with early-stage diseases feel perfectly fine.

All of which shows that “disease” isn’t a magic word of certainty. It’s a claim about mechanism, and mechanisms can be wrong.

How does a disorder differ, especially in mental health?

Blunt claim: “disorder” is the word medicine reaches for when function is disrupted and the full mechanism isn’t known. In mental health, nearly every diagnosis is a disorder, not a disease, because psychiatric conditions are identified by their patterns of thinking, emotion, and behavior, not by blood tests or scans.

The DSM-5, the American Psychiatric Association’s diagnostic manual, defines a mental disorder as a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior, reflecting a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. It adds that disorders are usually associated with significant distress or disability, and that expectable responses to common stressors, such as grief, don’t count. Socially deviant behavior alone doesn’t count either, unless it results from an individual dysfunction.

Notice something striking: the DSM definition uses the word syndrome inside its definition of disorder. That’s not a slip. It reflects the fact that most psychiatric diagnoses start as recognized symptom clusters.

Philosopher-psychologist Jerome C. Wakefield offered the most discussed account of what makes something a mental disorder. His harmful dysfunction analysis says a disorder has two components: a factual one (the failure of a mental mechanism to perform the function it evolved to perform) and a value one (the failure causes harm, as judged by social standards). Sadness after a loss, in this view, isn’t a disorder because the mechanism is working as designed; sadness with no relationship to circumstances might be.

Critics have attacked both halves. Some argue that we don’t know enough about the evolved functions of mental mechanisms to say when they’ve failed, and others argue that disorders can exist without any clear malfunction. The debate is live, and Wakefield has responded at length to his philosophical critics.

In daily clinical life, a disorder generally requires three things:

1. A recognizable symptom pattern that meets listed criteria.
2. Clinically significant distress or impairment at work, school, home, or in relationships.
3. Exclusion of other explanations, such as substance effects, medical illness, or normal reactions to life events.
4. A duration long enough to suggest more than a passing state.
5. Some reason to think the pattern reflects underlying dysfunction, not just social disagreement.

Imagine Dana (an illustrative composite), anxious before a big exam and sleepless for three nights. Normal. Now picture someone who’s worried about nearly everything on most days for six months, can’t relax, can’t concentrate, and is losing work hours because of it. That pattern crosses the threshold the word “disorder” is meant to capture.

The key phrase is “clinically significant.” Not every quirk is a disorder. Distress and impairment draw the line, and that line moves with context.

Why do the three words overlap so much?

Because medicine named things at different moments in history, with different levels of knowledge, and never went back to tidy the vocabulary. Names stick even when science moves on, which is why a condition’s label often tells you more about when it was discovered than what it is.

The clearest example is AIDS, short for acquired immunodeficiency syndrome. In the early 1980s doctors saw clusters of unusual infections and cancers in previously healthy people, a pattern with no known cause, so “syndrome” fit the evidence. Within a few years, researchers identified a virus, HIV, as the cause. Today, we refer to HIV infection as the disease process and AIDS as its advanced stage, yet the original name survives. A syndrome got explained and kept its name.

Reverse the pattern and you get conditions called “disease” that are more like syndromes. Parkinson’s disease is diagnosed largely by its clinical picture (tremor, rigidity, slowness), with the underlying neurodegeneration inferred. Researchers debate whether it is one disease or several overlapping ones. Alzheimer’s disease has recognizable pathology, but its causes seem to be many, and a diagnosis in life is still partly probabilistic.

And then there are plain historical accidents. Down syndrome and Tourette syndrome carry the names of physicians. “Disease” got attached to several conditions named in an era when the word meant simply “dis-ease,” a lack of ease. “Disorder” took hold in psychiatry partly to avoid implying that a biological cause had been found, and partly to avoid the baggage of older terms such as “illness” or “neurosis.”

Which brings up a point most overviews miss: these words partly reflect professional politics. Calling something a disease can strengthen its claim for research funding and insurance coverage. Calling it a syndrome can signal humility. Calling it a disorder can be a compromise that keeps clinicians, patients, and regulators reasonably happy.

A cluster of symptoms is also not always one thing. Chronic fatigue syndrome, for instance, may include several different conditions that look alike. Naming them together can help patients get care while hiding the very differences researchers need to find.

So when words overlap, the right reaction isn’t “somebody’s confused.” It’s “this condition is at a particular point in a long process of being understood.”

The vocabulary is a snapshot, not a verdict.

Is depression a disease or a disorder?

Officially, a disorder. Major depressive disorder is the DSM-5 diagnosis, and it is defined by a pattern of symptoms lasting at least two weeks, with significant distress or impairment. No blood test or brain scan confirms it, and researchers haven’t identified a single cause. Many clinicians still speak of depression as an illness, and plenty of patients find the “disease” framing helpful. Both are defensible; they answer slightly different questions.

Psychiatrist Thomas Szasz famously went further. In a 1960 paper, “The myth of mental illness,” he argued that mental illnesses aren’t diseases in the medical sense, since they lack demonstrable bodily lesions, and that what we call mental illness is better described as problems in living. His critique was provocative and influential, and it has also been widely contested. Most psychiatrists today accept that mental disorders involve real biological processes and real suffering, while still acknowledging that the field’s classification has conceptual problems.

A more nuanced modern view comes from psychiatric philosopher Kenneth S. Kendler and colleagues, who argued in 2011 that psychiatric disorders aren’t like simple, single-cause diseases. They proposed that disorders are better seen as complex clusters of features held together by multiple causal mechanisms, with no single “essence.” Under this view, calling depression a “disease” in the same sense as tuberculosis would be misleading, while calling it “merely a label” would be equally off the mark.

Why does the distinction matter to someone with depression? Some people feel relief at hearing “it’s a disease.” It suggests that their suffering is real and not a moral failing. Others dislike it, because it implies something is broken in them and might reduce a sense of agency. Neither response is wrong. Language lands differently on different people.

Consider Jon (an illustrative composite), who spent two years telling himself he was lazy. When his doctor explained that depression is a recognized medical condition with effective treatments, he felt something loosen in his chest. Meanwhile his friend Aisha, who also has depression, prefers to call hers “a rough patch with a medical component” because that framing helps her keep working on habits and relationships.

What’s clearly supported by evidence is the practical bit: depression is common, impairing, and treatable. Psychotherapies such as cognitive behavioral therapy, antidepressant medication, and combinations of the two help many people. If low mood has lasted two weeks or more, or you’re having thoughts of suicide, talk to a primary care doctor or mental health professional. In the US, call or text 988; in Canada, 9-8-8; in the UK or Ireland, Samaritans at 116 123; in Australia, Lifeline at 13 11 14; in New Zealand, 1737.

So disease or disorder? The better question may be what the word helps you do next.

How does a syndrome become a recognized disease?

Through a long, unglamorous process of description, testing, and replication. In 1970, psychiatrists Eli Robins and Samuel B. Guze published a landmark paper in the American Journal of Psychiatry proposing criteria for establishing the diagnostic validity of a psychiatric illness, applied to schizophrenia. It has since become one of the most cited papers in the field.

Their approach had five phases, and it works as a general template for how a syndrome earns credibility:

1. Clinical description: careful, consistent accounts of symptoms, onset, and course.
2. Laboratory studies: chemical, physiological, or imaging findings that distinguish the condition.
3. Delimitation from other disorders: showing it’s not just a variant of something else.
4. Follow-up studies: evidence that the condition runs a predictable course over time.
5. Family studies: evidence that it runs in families, suggesting heritable influences.

Notice how much of this is about reliability and prediction instead of a smoking-gun cause. Medicine often validates conditions through patterns long before anyone understands the mechanism. That’s how, historically, many diseases were first recognized: a distinct picture, a consistent course, and only later a cause.

The most dramatic transition happens when researchers find a mechanism. Once a causative agent or process is established with fairly high certainty, physicians may begin to speak of a disease, not just a syndrome. HIV and AIDS illustrate the shape of this path, as do conditions that were once vague clusters and later turned out to be caused by specific genetic mutations.

Psychiatry hasn’t had the same luck. Despite decades of imaging, genetics, and biomarker work, most psychiatric diagnoses still can’t be confirmed with laboratory tests. Critics point to this as a failure of the field; defenders note that many general medical diagnoses also lack lab tests and are made on clinical grounds, such as migraine, which is diagnosed by symptom pattern.

Genetic findings complicate the picture further. Large studies show overlapping genetic risk across supposedly separate disorders, which suggests our categories may not carve nature at its joints. That’s one reason many researchers are exploring dimensional approaches that describe symptoms along continua.

What would count as proof that a psychiatric syndrome is a disease? A reliable biomarker, a clear mechanism, and a treatment that targets it. We’re not there yet for most conditions, and honesty about that is better than overselling.

Why do these labels matter in real life?

Because they shape treatment, access, stigma, and identity. A label can decide whether a person receives support at school, qualifies for disability accommodations, or has costs covered by insurance. Coverage rules vary widely across countries and plans, so check the specifics with your own provider or insurer rather than assuming one term unlocks anything.

Psychiatrist Allen Frances, who chaired the DSM-IV task force, became one of the field’s most prominent critics of diagnostic expansion. In his book Saving Normal (2013), he argued that loosening diagnostic boundaries risks turning ordinary shyness, grief, or eccentricity into disorders, and that this “diagnostic inflation” can lead to unnecessary treatment. His critique doesn’t deny that real disorders exist; it warns that labels can be applied too eagerly.

The opposite problem exists too. Under-diagnosis keeps people from help: women with ADHD, adults with autism, and people with conditions such as endometriosis often go years without answers. A cluster of symptoms that doesn’t yet have a recognized name can leave patients feeling dismissed.

Stigma follows the words in complicated ways. Research on public attitudes suggests the “illness like any other” framing can reduce blame but sometimes increases beliefs that a person is fundamentally different or unpredictable. Language isn’t neutral. “Disorder” can feel clinical and cold; “syndrome” can sound exotic; “disease” can sound severe or contagious, which is why people sometimes recoil from it.

There’s a personal dimension too. Some patients embrace identity-first language (“I’m autistic”), while others prefer person-first language (“I have autism”). Some communities, such as many in the autism and Deaf communities, resist the word “disorder” altogether and prefer terms like difference or neurodivergence. Respect for those preferences is good manners and good care.

Think about Priya (an illustrative composite), told she has irritable bowel syndrome. For years, her stomach pain was brushed off as stress. The diagnosis gave her access to dietary strategies, a gut-directed therapy referral, and, maybe most of all, permission to take her symptoms seriously. For her, “syndrome” was validation, not vagueness.

What to ask your clinician: What’s the evidence for this diagnosis? What’s known about the cause? What are the treatment options, and how will we know if they’re working? Those questions matter more than the noun.

The word on your chart shapes how others see you. You get a say in how you see it.

Quick examples: which word belongs where?

Sorting actual conditions shows how the logic works and where it breaks. These are standard usages, not strict rules.

• Type 2 diabetes is a disease: identifiable mechanisms (insulin resistance), objective lab tests, and targeted treatments.
• Metabolic syndrome is a syndrome: a cluster of risk factors that travel together, not a single illness with one cause.
• Major depressive disorder is a disorder: diagnosed from symptom patterns and impairment, with mixed biological findings.
• Down syndrome is a syndrome with a known genetic cause, and it isn’t treated as a disease in the usual sense.
• Parkinson’s disease is called a disease: characteristic neuropathology, though diagnosis relies largely on clinical signs.
• Post-traumatic stress disorder is a disorder: defined by a trauma-linked symptom pattern, with growing biological research behind it.

Mixed cases are everywhere. Autism spectrum disorder is officially a disorder in the DSM-5 but is considered by many people a form of neurodevelopmental difference. Chronic fatigue syndrome, also called myalgic encephalomyelitis, has moved between labels as research shifted, and many patients argue that the term “syndrome” understated how disabling it is. Heart failure is technically a syndrome, since it can arise from several different causes, though most people think of it as a disease.

A tidy way to think about it: syndromes describe what we see, disorders describe how functioning is disrupted, and diseases describe what’s going wrong underneath. Real conditions often involve more than one of these at once.

Notice too that severity isn’t coded in the words. Plenty of syndromes are mild, and some diseases are minor. A disorder can be life-threatening (anorexia nervosa has one of the highest mortality rates among psychiatric conditions), while a disease can be a nuisance. If someone says “it’s only a syndrome,” they’re mistaken about what the word means.

When you meet a new term, ask three plain questions: What are the symptoms? What’s known about the cause? What helps? Those answers do more work than the label.

How should you talk about your own diagnosis?

However feels accurate and useful to you. There’s no universal rule, and different words work for different people. But a few habits help conversations with clinicians, family, and employers.

First, use the official name when dealing with doctors, insurers, schools, or workplaces, because forms and criteria are built around those terms. Second, describe function in everyday life: what you can’t do, what’s harder, what helps. Specific examples, such as “I can’t focus on a screen for more than ten minutes without losing the thread,” carry more weight than any label.

Third, ask about uncertainty. If a clinician says “syndrome,” ask whether the cause is known and what’s being done to understand it. If they say “disorder,” ask what the diagnosis is based on and whether other conditions have been ruled out. If they say “disease,” ask what the underlying process is and how it’s being monitored. Good clinicians welcome these questions.

Fourth, notice how the word lands on you. If a label brings relief, hold onto that. If it brings shame, tell your clinician; the framing can often be adjusted without changing the facts. And fifth, don’t let the vocabulary hijack decisions. Treatment choices should rest on evidence about what works for your condition, not on whether the noun sounds scary.

For friends and family, a courtesy: ask how the person prefers to describe their condition, and use that language. Avoid “just” (“it’s just a syndrome”) and avoid diagnosing from afar.

Which word fits your situation? Your clinician can say what’s known. You can say what it feels like. Both belong in the conversation.

FAQs about Syndrome, Disorder, and Disease

What is the main difference between a syndrome and a disease?

A syndrome is a group of signs and symptoms that occur together, and its cause may be unknown or varied. A disease usually implies a specific underlying pathology or cause, such as an infection, a genetic mutation, or tissue damage. In practice, the line blurs: Down syndrome has a known genetic cause, and AIDS is called a syndrome even though it is caused by HIV. The terms mostly reflect how much was known when the condition was named. If you hear “syndrome,” it often signals a recognizable pattern, not necessarily an unexplained or minor problem.

Is a disorder the same as a disease?

No, although they overlap. A disorder generally refers to disrupted functioning, such as in thinking, emotion, behavior, or a body system, that causes distress or impairment. It’s the standard term in psychiatry, where diagnoses rest on symptom patterns instead of lab tests. A disease usually points to a defined biological pathology. Some conditions carry both labels depending on context, and clinicians may use them casually as near-synonyms. If the distinction matters for your care, ask what the diagnosis is based on and what’s known about its mechanism.

Why is it called a syndrome if the cause is known?

Because names often outlive the discoveries that explain them. Down syndrome, for example, was described in the nineteenth century, and its cause, an extra copy of chromosome 21, was identified in 1959, yet the original label stayed. Similarly, AIDS retained its name after HIV was discovered. In some cases “syndrome” is also preferred because the condition has a wide range of features that don’t fit the idea of a single illness. History and convention, not strict logic, often decide which word wins.

Is depression a disease or a disorder?

Officially it’s a disorder: major depressive disorder in the DSM-5, diagnosed by a pattern of symptoms lasting at least two weeks with significant distress or impairment. Many doctors and patients also call it an illness or disease, since it involves biological processes and responds to treatment, though no single cause or lab test has been established. Critics such as Thomas Szasz argued mental illnesses aren’t diseases in the medical sense, a view that remains contested. Practically, the label matters less than recognizing that depression is common, real, and treatable with therapy, medication, or both.

Can a syndrome turn into a disease?

The condition doesn’t change, but our understanding of it can. When researchers identify a specific cause or mechanism, clinicians may start calling the condition a disease instead of a syndrome. The path from observation to explanation can take decades. Robins and Guze outlined stages for validating a psychiatric illness, including clinical description, laboratory studies, separation from other conditions, follow-up, and family studies. Many conditions remain syndromes for a long time, and some never become diseases in the strict sense because they have multiple causes. The word reflects the state of knowledge.

Does the label affect treatment or insurance coverage?

It can, though details vary a great deal by country, insurer, and plan. Diagnoses recorded in classification systems such as the DSM or ICD are typically what clinicians use for treatment planning and paperwork. A condition with a recognized diagnostic code is often easier to document and get support for than a vague cluster of symptoms. Because rules differ, don’t assume that “disease” automatically gets coverage and “syndrome” doesn’t. Ask your clinician or insurer what is needed for the services you want, and keep copies of your diagnostic records.

Why do some people dislike the word disorder?

Some feel it frames a difference as a defect. This is common in the autism and ADHD communities, where many prefer terms like neurodivergence, difference, or condition, and where people may object to pathologizing traits that also bring strengths. Others find “disorder” accurate and validating because it recognizes real impairment. Critics of overdiagnosis, such as Allen Frances, also worry that the label can be stretched to cover ordinary variation. A sensible approach is to use the clinical term where needed for care and to follow the individual’s own preference in everyday conversation.

Which term is the most serious?

None. Severity isn’t built into the words. A syndrome can be mild or life-threatening, a disorder can be manageable or deadly, and a disease can be a minor nuisance or fatal. Anorexia nervosa is a psychiatric disorder with high mortality, while some conditions labeled diseases cause little trouble. What matters for seriousness is how the condition affects functioning, how it progresses, and what treatments exist. If you’ve been given a diagnosis, ask about prognosis, symptoms to watch for, and what changes in your situation should prompt you to seek help sooner.

Bibliography

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
• Boorse, C. (1977). Health as a theoretical concept. Philosophy of Science, 44(4), 542-573.
• Down, J. L. H. (1866). Observations on an ethnic classification of idiots. London Hospital Reports, 3, 259-262.
• Frances, A. (2013). Saving normal: An insider’s revolt against out-of-control psychiatric diagnosis, DSM-5, big pharma, and the medicalization of ordinary life. William Morrow.
• Kendler, K. S., Zachar, P., & Craver, C. (2011). What kinds of things are psychiatric disorders? Psychological Medicine, 41(6), 1143-1150.
• Robins, E., & Guze, S. B. (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry, 126(7), 983-987.
• Szasz, T. S. (1960). The myth of mental illness. American Psychologist, 15(2), 113-118.
• Wakefield, J. C. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47(3), 373-388.