The cluster may be associated with physical abnormality or may not. According to these authorities, disease is not an observable phenomenon, but a social relationship. Linguistic considerations help to illuminate the differences between bodily and mental disease, as well as between disease and diagnosis. We do not attribute motives to a person for having leukemia, do not say that a person has reasons for having glaucoma, and would be uttering nonsense if we asserted that diabetes has caused a person to shoot the President. However, we can and do say all of these things about a person with a mental illness.
Mental diseases are patterns of personal conduct, unwanted by the self or others.
Psychopathology is diagnosed by finding behavioral, not physical, abnormalities in bodies. Disease qua psychopathology cannot be asymptomatic. Mental diseases are invented and then given a name, such as attention deficit disorder. In the case of bodily illness, the clinical diagnosis is a hypothesis, typically confirmed or disconfirmed through an autopsy. It is not possible to die of a mental illness or to find evidence of it in organs, tissues, cells, or body fluids during an autopsy.