Dennis B. Kottler, MD

        Westlake Village, CA

        Appointments:   818-991-8376 

        Email:   doc@psychiatrix.com

        Return to Homepage

Click image for more information:


DIAGNOSES* conveniently describe clusters of symptoms.  Insurance companies and medical research require them.  Diagnoses are helpful in guiding treatment.

But, there are problems.  How high a blood pressure is "hypertension?"  Is memory loss part of "natural aging" or a disease?  How much anxiety is "generalized anxiety disorder."  These guidelines constantly change.  Furthermore, common problems, such as chronic "stress," do not correspond to any particular psychiatric diagnosis.**

Apart from "labels" a better approach would look at:

        1 - Presenting problems (self-observed and observed by others)

        2 - Degree of discomfort - variation over time and circumstances

       3 - Social dynamics - how others affect you and you affect them

        3 - Strengths and "weaknesses"

                including strategies that have worked in the past

        4 - Identified areas for change


*Note:  Dr. Kottler participated in the field trials which were used to troubleshoot the DSM IV (Diagnostic and Statistical Manual of Mental Disorders 4th Ed-Revised) regarding measures of validity and reliability.  A DSM V is in the works but not yet published.  It will emphasize that people fall within a spectrum for various diagnoses.  Of course, this still begs the question at what point does a problem require treatment, and at what point is psychopharmacology indicated.

**Note:  The DSM IV diagnosis of "acute stress disorder" pertains to a reaction to a particular, stressful event, not generalized stress. 

Return to Top

Return to Homepage

Appointments:   818-991-8376 

Email:   doc@psychiatrix.com