Abstract

What kind of thing is a psychiatric disorder? At present, this is the central question in the philosophy of psychiatry. Answers tend toward one of two opposing views: realism, the view that psychiatric disorders are natural kinds, and constructivism, the view that disorders are products of classificatory conventions. The difficulties with each are well rehearsed. One compelling third-way solution, developed by Peter Zachar, holds that disorders are practical kinds. Proponents of this view are left with the difficult task of explaining what makes practical kinds practical. Kendler, Zachar, and Craver have recently developed a new third-way solution, according to which psychiatric disorders are mechanistic property cluster kinds. This account, already influential in the philosophy of psychiatry, holds that the usefulness of psychiatric kinds is explained by the stability of multilevel mechanisms that generate psychiatric symptoms. We argue that this account, like any that purports to address the central question in the philosophy of psychiatry without first attending carefully to the nature of psychiatry and the difference between its constituent scientific and philosophical parts, will ultimately be committed to untenable views about the nature of psychiatric science, the aims and limitations of scientific inquiry and mechanistic explanations, and the role of values in psychiatry.