Clinical classification in mental health at the cross-roads: which direction next?
Open Access
- 14 May 2013
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Medicine
- Vol. 11 (1), 125-14
- https://doi.org/10.1186/1741-7015-11-125
Abstract
After 30 years of consensus-derived diagnostic categories in mental health, it is time to head in new directions. Those categories placed great emphasis on enhanced reliability and the capacity to identify them via standardized checklists. Although this enhanced epidemiology and health services planning, it failed to link broad diagnostic groupings to underlying pathophysiology or specific treatment response. It is time to adopt new goals that prioritize the validation of clinical entities and foster alternative strategies to support those goals. The value of new dimensions (notably clinical staging), that are both clinically relevant and directly related to emerging developmental and neurobiological research, is proposed. A strong emphasis on ‘reverse translation’ (that is, working back from the clinic to the laboratory) underpins these novel approaches. However, it relies on using diagnostic groupings that already have strong evidence of links to specific risk factors or patterns of treatment response. The strategies described abandon the historical divides between clinical neurology, psychiatry and psychology and adopt the promotion of pathways to illness models.This publication has 187 references indexed in Scilit:
- Diagnostic performance of a combination of Mini-Mental State Examination and Clock Drawing Test in detecting Alzheimer’s diseaseNeuropsychiatric Disease and Treatment, 2013
- Pathways to alcohol-induced brain impairment in young people: A reviewCortex, 2013
- Mania With and Without Depression in a Community Sample of US AdolescentsArchives of General Psychiatry, 2012
- Association between pro- and anti-inflammatory cytokine genes and a symptom cluster of pain, fatigue, sleep disturbance, and depressionCytokine, 2012
- Concurrent binge drinking and depression among Canadian youth: prevalence, patterns, and suicidalityAlcohol, 2012
- Knockdown of Clock in the Ventral Tegmental Area Through RNA Interference Results in a Mixed State of Mania and Depression-Like BehaviorBiological Psychiatry, 2010
- The circadian basis of mood disorders: Recent developments and treatment implicationsEuropean Neuropsychopharmacology, 2008
- Dimensionality and the category of major depressive episodeInternational Journal of Methods in Psychiatric Research, 2007
- Vascular depression in older people with diabetesDiabetologia, 2006
- Depressive Symptoms, Vascular Disease, and Mild Cognitive ImpairmentArchives of General Psychiatry, 2006