Sharp Brains: Brain Fitness and Cognitive Health News

Neuroplasticity, Brain Fitness and Cognitive Health News

Icon

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

Leave a Reply...

Loading Facebook Comments ...

Leave a Reply

Categories: Cognitive Neuroscience, Health & Wellness

Tags: , , , , , , , ,

About SharpBrains

As seen in The New York Times, The Wall Street Journal, BBC News, CNN, Reuters,  SharpBrains is an independent market research firm tracking how brain science can improve our health and our lives.

Search in our archives

Follow us and Engage via…

twitter_logo_header
RSS Feed

Watch All Recordings Now (40+ Speakers, 12+ Hours)