Epistemic Inversion in Psychiatry: When the Object Dictates the Theory

This article examines the phenomenon of epistemic inversion in contem-porary psychiatry, wherein diagnostic classification increasingly precedes andconstrains theoretical development. We argue that this reversal, exemplifiedby symptom-based systems such as the DSM, leads to a loss of epistemicnormativity and undermines the interpretive dimension of clinical reason-ing. Through a critical engagement with historical and philosophical tradi-tions (Canguilhem, Hacking) and contemporary debates in the philosophy ofmedicine (Khalidi, Kendler, Brigandt), we analyze the implications of object-led nosology on the ontology and intelligibility of mental disorders. To re-construct epistemic coherence, we introduce the concept of constraint regimesstructural, empirical, and projective, as a framework for understanding howdiagnostic stability emerges from the interplay of normative, contextual, andbiological factors. We advocate for a situated model of rationality that restoresthe mediating role of clinical expertise, challenges classificatory reification, andreorients psychiatry toward an interpretive and normatively robust epistemol-ogy.