Sharp Brains: Brain Fitness and Cognitive Health News

Neuroplasticity, Brain Fitness and Cognitive Health News


Time to revamp psychiatry and mental health in light of modern neuroscience?

mentalhealthpuzzleTrans­form­ing Diag­no­sis (arti­cle by Thomas Insel, Direc­tor of the NIMH): “In a few weeks, the Amer­i­can Psy­chi­atric Asso­ci­a­tion will release its new edi­tion of the Diag­nos­tic and Sta­tis­ti­cal Man­ual of Men­tal Dis­or­ders (DSM-5)…While DSM has been described as a “Bible” for the field, it is, at best, a dic­tio­nary, cre­at­ing a set of labels and defin­ing each. The strength of each of the edi­tions of DSM has been “reli­a­bil­ity” – each edi­tion has ensured that clin­i­cians use the same terms in the same ways. The weak­ness is its lack of valid­ity. Unlike our def­i­n­i­tions of ischemic heart dis­ease, lym­phoma, or AIDS, the DSM diag­noses are based on a con­sen­sus about clus­ters of clin­i­cal symp­toms, not any objec­tive lab­o­ra­tory mea­sure. In the rest of med­i­cine, this would be equiv­a­lent to cre­at­ing diag­nos­tic sys­tems based on the nature of chest pain or the qual­ity of fever. Indeed, symptom-based diag­no­sis, once com­mon in other areas of med­i­cine, has been largely replaced in the past half cen­tury as we have under­stood that symp­toms alone rarely indi­cate the best choice of treatment.

Patients with men­tal dis­or­ders deserve bet­ter. NIMH has launched the Research Domain Cri­te­ria (RDoC) project to trans­form diag­no­sis by incor­po­rat­ing genet­ics, imag­ing, cog­ni­tive sci­ence, and other lev­els of infor­ma­tion to lay the foun­da­tion for a new clas­si­fi­ca­tion system…”

No One Is Aban­don­ing the DSM, but It Is Almost Time to Trans­form It (SciAm blog post): “Let me be clear: men­tal ill­ness is real, but the dis­crete cat­e­gories of ill­ness in the DSM might not exist out­side its pages…NIMH has, how­ever, been work­ing on an endeavor known as the Research Domain Cri­te­ria Project, or RDoC for short, which encour­ages psy­chol­o­gists, neu­ro­sci­en­tists and other sci­en­tists to think out­side the DSM box—to begin tran­si­tion­ing away from estab­lished DSM dis­or­ders and instead study fun­da­men­tal bio­log­i­cal and cog­ni­tive processes under­ly­ing men­tal ill­ness. The impor­tant dis­tinc­tion here is between clin­i­cal prac­tice and research. The NIMH is not in any way say­ing that clin­i­cians should stop using the DSM, but it does think that the DSM has con­strained research…

Insel echoed these com­ments in a sep­a­rate e-mail: “We can­not ‘ditch’ or ‘reject’ terms like schiz­o­phre­nia or bipo­lar. We just need to view them as con­structs, per­haps includ­ing many dif­fer­ent dis­or­ders that require dif­fer­ent treat­ments or obscur­ing dis­or­ders than cut across the cur­rent cat­e­gories. A symptom-only sys­tem will not be suf­fi­cient for iden­ti­fy­ing brain disorders—whether the ini­tial label is demen­tia or schizophrenia…”

Related arti­cles:

Pic cour­tesy of Big­Stock­Photo

Be Socia­ble, Share!
    Print This Article Print This Article

    Categories: Cognitive Neuroscience, Health & Wellness

    Tags: , , , , , , , ,

    New online course: How to Nav­i­gate Con­ven­tional and Com­ple­men­tary ADHD Treat­ments for Healthy Brain Development (early bird rates end April 1st)

    Haven’t read this book yet?

    Follow us via


    Welcome to

    As seen in The New York Times, The Wall Street Jour­nal, CNN and more, Sharp­Brains is an inde­pen­dent mar­ket research firm track­ing health and well­ness appli­ca­tions of brain science.
    FIRST-TIME VISITOR? Dis­cover HERE the most pop­u­lar resources at
    Enter Your Email to receive Sharp­Brains free, monthly eNewslet­ter:
    Join more than 50,000 Sub­scribers and stay informed and engaged.