[Is presentation of symptoms enough for detection of an illness? On the correlation between symptoms, findings, diagnosis and disability].

In 1999, the IV. civil division of the German Federal Supreme Court has issued a verdict which states that for some diseases the medical proof of a disease may be established solely on grounds of the individual complaints supporting the respective diagnosis. In the eyes of the psychiatrist, this statement is wrong and results from a confusion of diagnosis and disease. It also reveals a curious misconception of how psychiatric diagnoses, as instances of non-physical disorders, are established. Responsible for the confusion are the modern diagnostic manuals, which are misunderstood and thus misused as containing a list of diseases. However, the diagnostic manuals only intend to classify characteristic complexes of complaints and signs, without establishing them as diseases. The present paper explores the relationship between diagnosis and disease and explains how psychiatric diagnoses are made.