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In June 2019, the Superior Health Council of Belgium published an advisory on “DSM-5–Use and status of the diagnostic manual and of mental health disorder classifications”. In Belgium, their advice served to awaken age-old debates and polemical arguments between dimensional and categorical approaches to psychiatric phenomena. The advisory took up a clear and unreserved position in favor of a dimensional approach, and condemned DSM-5 and the CIM for being naturalist categorical classifications.The aim of this article is to use this advisory from the Superior Health Council in Belgium as an opportunity to re-open an evergreen debate between categorical and dimensional approaches on one hand, and naturalist and constructivist classifications on the other, with a view to adding further depth to the Council's advice on the DSM. The article also attempts to clarify the clinical and political implications of these oppositions.