This book provides a critical evaluation of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Starting from a historical overview of the evolution in psychiatric diagnosis, Vanheule asserts that the diagnostic reliability of the DSM-5 is overrated: important factors that undermine its diagnostic reliability have never been sufficiently addressed and the common idea that the handbook is reliable rests on a biased interpretation of statistical data. The book argues that the DSM-5 builds on a narrow biomedical approach to mental disorders that neglects context, and proposes its replacement with a contextualizing model of mental health symptoms. Drawing from phenomenological psychiatry and Lacanian psychoanalysis, the author concludes that a reflexive account of psychopathology is urgently needed.