... and attach stigma to the diagnosed (labelled) patient. This essay will debate the reliability of classification systems and consider the influences of clinicians' training, and social and cultural bias on diagnosis. It will evaluate the validity of the categories in respect of their ability to provide descriptive, predictive and aetiologically valid data, and in addition will consider the ethical consequences of labelling. For a classification system to be reliable, different health officials should agree on the same diagnosis in a patient, although this is often difficult to achieve, Di Nardo showed in 1993 that there was 70% agreement in a study, demonstrating that a third of clinicians fail to reach a consensus (Archives of General Psychiatry (50) p251-256 1993). However, it has been argued that reliability cannot be achieved in view of the fact that doctors extract information about a patient using different techniques, they also have different standards of training ...

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