I give a history of approaches to psychiatric diagnoses, outlining Kraepelin, psychoanalysis, the neo-Kraepelinians and the DSM project. I outline current concerns with the DSM and outline alternatives like RDoC, HiTOP and person centred approaches. This shows how psychiatry has alternated between favouring and rejecting a disease centred approach. I consider how philosophers have aimed to defend psychiatric diagnoses by seeing the correct psychiatric diagnoses as natural kinds. However, it is recognised that currently employed psychiatric diagnoses are not natural kinds. This means we need a new account of scientifically legitimate psychiatric diagnoses that is not based upon them being natural kinds.