Physical signs in psychiatry: a step towards evidence-based medicine

INTRODUCTION: The descriptive nature of psychiatry is embedded in the traditions of Kraepelin, Bleuler and Freud. Diagnostic guidelines in both ICD-10 and DSM-IV are stated to be based on the "clinical description of the variety of concepts'' and are based on the subjective complaint s, i.e. symptoms. METHOD: In particular, we argue that no significant effort has been made to segregate the presence of accompanying physical signs in Major Depressive Illness, DSM-IV 296.2x, and Panic Disorder Without Agoraphobi a, DSM-IV 300.01. RESULT: These physical signs are psychophysiological correlates of clinically significant depression and anxiety. Advances in structural biology, genetic engineering and brain imaging provide an opportunity to narrow the gap between physical signs and psychiatric symptoms in psychiatry. CONCLUSION: Therefore we suggest that the next revisions of the DSM and the ICD classifications lead the way in incorporating physical signs alongside those symptoms pertaining to each psychiatric illness.