The '04 PSD 6.0 I had in my work E-350 was fine-AFTER they replaced the EGR cooler, oil cooler, head gaskets, FICM, FIPS, 6 injectors (later), body off the frame fpr 2 months because Ford had a national backorder on the coolers. Other than a tendency to plug the air filter with sludge somewhat it was fine at over 250,000 miles when it lost reverse. BUT-the dealer who worked on it (at 50K, still under engine warranty) was wanting an EXTRA $7500 for all the labor it took to get the van body off it to fix it! Much laughter ensued, they didn't get an extra dime... All the while, we had an '03 7.3 PSD E-350 van make it to 700K with no major issues until doors started falling off!