scholarly journals Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health’s Research Domain Criteria (RDoC)

2017 ◽  
Vol 18 (2) ◽  
pp. 72-145 ◽  
Author(s):  
Lee Anna Clark ◽  
Bruce Cuthbert ◽  
Roberto Lewis-Fernández ◽  
William E. Narrow ◽  
Geoffrey M. Reed
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
International Classification Of Diseases ◽  
The United States ◽  
Classification Systems ◽  
Prescribe Medication ◽  
Research Domain Criteria ◽  
Classification Of Diseases ◽  
Key Issues ◽  
Research Domain

The diagnosis of mental disorder initially appears relatively straightforward: Patients present with symptoms or visible signs of illness; health professionals make diagnoses based primarily on these symptoms and signs; and they prescribe medication, psychotherapy, or both, accordingly. However, despite a dramatic expansion of knowledge about mental disorders during the past half century, understanding of their components and processes remains rudimentary. We provide histories and descriptions of three systems with different purposes relevant to understanding and classifying mental disorder. Two major diagnostic manuals—the International Classification of Diseases and the Diagnostic and Statistical Manual of Mental Disorders—provide classification systems relevant to public health, clinical diagnosis, service provision, and specific research applications, the former internationally and the latter primarily for the United States. In contrast, the National Institute of Mental Health’s Research Domain Criteria provides a framework that emphasizes integration of basic behavioral and neuroscience research to deepen the understanding of mental disorder. We identify four key issues that present challenges to understanding and classifying mental disorder: etiology, including the multiple causality of mental disorder; whether the relevant phenomena are discrete categories or dimensions; thresholds, which set the boundaries between disorder and nondisorder; and comorbidity, the fact that individuals with mental illness often meet diagnostic requirements for multiple conditions. We discuss how the three systems’ approaches to these key issues correspond or diverge as a result of their different histories, purposes, and constituencies. Although the systems have varying degrees of overlap and distinguishing features, they share the goal of reducing the burden of suffering due to mental disorder.

Research Domain Criteria and OCD

2017 ◽  
Author(s):  
Eyal Kalanthroff ◽  
Gideon E. Anholt ◽  
Helen Blair Simpson
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Disorders ◽  
The United States ◽  
Self Report ◽  
Research Domain Criteria ◽  
Diagnostic Systems ◽  
Behavioral Measures ◽  
Research Domain

This chapter discusses the Research Domain Criteria (RDoC) project, an initiative of the National Institutes of Mental Health (NIMH) of the United States to develop for research purposes new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures, and explores how the hallmark symptoms of OCD (obsessions, compulsions, and anxiety) can be mapped onto RDoC domains. Unlike current categorical diagnostic systems (e.g., DSM), RDoC seeks to integrate many levels of information (from genomics to self-report) to validate dimensions defined by neurobiology and behavioral measures that cut across current disorder categories. The chapter explores, for heuristic reasons, how the RDoC matrix might be used to elucidate the neurobehavioral domains of dysfunction that lead to the characteristic symptoms of OCD. It then selectively reviews the OCD literature from the perspective of the RDoC domains, aiming to guide future transdiagnostic studies to examine specific neurobehavioral domains across disorders.

Current diagnostic criteria

2018 ◽  
Author(s):  
Luis Augusto Rohde ◽  
Christian Kieling ◽  
Giovanni Abrahão Salum
Keyword(s):  
International Classification Of Diseases ◽  
Research Domain Criteria ◽  
Statistical Manual ◽  
Adhd Diagnosis ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases ◽  
History Of ◽  
Research Domain ◽  
Clinical Category

In this chapter we describe the history of ADHD diagnosis and how it is currently conceptualized in two main classificatory manuals: the Diagnostic and Statistical Manual for the Mental Disorders (DSM) and the International Classification of Diseases (ICD). We also outline differences between DSM and ICD manuals and review discussions in the realm of the 11th edition of the ICD, in its journey to increase clinical utility. Lastly, we discuss the research domain criteria and how this initiative might affect ADHD diagnosis in the future. We conclude by offering a perspective that acknowledges both the limitations of our current classificatory systems, but also points out their paramount importance to clinical practice. ADHD, as currently defined by DSM and ICD, is a well validated clinical category and a useful diagnosis for communication among practitioners, researchers, and for selecting treatments and care for patients.

Classification and the British Glossary of Mental Disorders: Some Experience of its Use

1971 ◽  
Vol 119 (551) ◽  
pp. 413-418 ◽  
Author(s):  
J. R. M. Copeland
Keyword(s):  
New York ◽  
Mental Disorders ◽  
International Classification Of Diseases ◽  
The United States ◽  
World Health ◽  
Psychiatric Institute ◽  
Diagnostic And Statistical Manual ◽  
Standardized Interview ◽  
Classification Of Diseases ◽  
Eighth Edition

A Glossary of Mental Disorderswas published in 1968, prepared by the Registrar-General's Advisory Committee on Medical Nomenclature and Statistics. The document used as a basis the Eighth Edition of the World Health Organization's International Classification of Diseases (I.C.D.), Section V, which deals with mental disorders and mental subnormality. For the first time in this country the meaning of the categories listed in the I.D.C. are described, and the new Glossary stands beside the Second Edition of the American Diagnostic and Statistical Manual (D.S.M. II) which was also published in 1968. The psychiatrists working on the United States-United Kingdom Diagnostic Project at the Institute of Psychiatry, Maudsley Hospital, London, and the Psychiatric Institute, New York, made diagnoses according to the new Glossary descriptions on 820 hospital in-patients drawn from both sides of the Atlantic and interviewed using a standardized interview. The comments contained in this article are based on their experience.

The Present and Future of Psychiatric Diagnosis

2017 ◽  
Author(s):  
Steven E. Hyman
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Signs And Symptoms ◽  
International Classification Of Diseases ◽  
Diagnostic Classification ◽  
Statistical Manual ◽  
Classification Schemes ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases

Psychiatric disorders are currently diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders and the closely related International Classification of Diseases. Both diagnostic classification schemes are descriptive and based on a collection of signs and symptoms associated with a given disorder. The fundamental weakness of the schemes is that they are not based on the underlying genetic or neurobiological etiology or pathophysiology of a disorder which of course remain unknown for all common psychiatric syndromes. As more is learned about the biological basis of a mental disorder it will be possibly increasingly to build more accurate diagnostic schemes with greater prognostic and treatment validity.

Anxieties Over the Diagnostic and Statistical Manual of Mental Disorders

CNS Spectrums ◽  
2001 ◽  
Vol 6 (11) ◽  
pp. 890-890
Author(s):  
Michael Trimble
Keyword(s):  
Mental Disorders ◽  
International Classification Of Diseases ◽  
The United States ◽  
Exclusion Criteria ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm V ◽  
Classification Of Diseases ◽  
Dsm Iv

Rumor has it that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) is on the way. Apart from giving the American Psychiatric Association an enormous financial boost, this should be an opportunity to improve on some of the terrible intellectual lapses of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Revised (DSM-IV-R), to bring DSM and the International Classification of Diseases (ICD) schemes closer together, and to expand on biological and other markers as diagnostic components in the classificatory process. It is hoped that more than the first of these possibilities will be realized.Since the publication of the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, (DSM-III), the DSM manuals have brought a measure of good sense to clinical practice and have improved communication among researchers, so that at least in theory schizophrenia is similar on both sides of the Atlantic, and most probably is similar on both coasts of the United States. The slavish adherence to listed criteria has developed a sense of renewed interest in phenomenology of a practical kind, and exclusion criteria mean that not all individuals who visit a psychiatrist's office can be guaranteed a diagnosis. The distinction between Axis 1 and Axis 2 categories and the removal of any psychoanalytic taints was a stunning acceptance of Jaspers pace Freud.

Evolution and Mental Disorders

2018 ◽  
pp. 129-152
Author(s):  
Marco Del Giudice
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Psychiatric Comorbidity ◽  
Broad Sense ◽  
Network Approach ◽  
Research Domain Criteria ◽  
Developmental Processes ◽  
Definition Of ◽  
Research Domain

The chapter discusses the definition of mental disorder, reviews the biological explanations for vulnerability to disease, and presents a detailed taxonomy of undesirable conditions that may be regarded as disorders in a broad sense (whether or not they involve genuine dysfunctions). After detailing the main evolutionary and developmental processes that can lead to psychopathology, the chapter addresses some important questions about the structure and classification of disorders and the nature of psychiatric comorbidity. The chapter also considers the strengths and weaknesses of other emerging approaches: computational psychiatry, the network approach to psychopathology, the Research Domain Criteria (RDoC), and transdiagnostic models such as the Hierarchical Taxonomy of Psychopathology (HiTOP).

Classification

2017 ◽  
pp. 21-34
Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel
Keyword(s):  
International Classification Of Diseases ◽  
Classification Systems ◽  
World Health ◽  
Psychiatric Classification ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
History Of ◽  
Key Issues

‘Classification’ introduces concepts of mental illness before briefly reviewing the reasons for, and criticisms of, psychiatric classification. Key issues of reliability, validity, and stigma associated with classification are covered. After an overview of the history of classifications, the organizing principles of the two current major classification systems used in psychiatry (ICD-10 and DSM-5) are then outlined: the World Health Organization’s International Classification of Diseases (‘ICD-10’), and the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (‘DSM-5’). Additional schemes, used in particular countries, are also briefly mentioned. Finally, the chapter summarizes how psychiatric classification may develop in the future, with particular reference to ICD-11, which is due in 2018 or 2019.

Factitious disorder and malingering

2020 ◽  
pp. 1342-1349
Author(s):  
Thomas Merten ◽  
Harald Merckelbach
Keyword(s):  
Mental Disorders ◽  
Sick Leave ◽  
Mental Disorder ◽  
Somatic Symptoms ◽  
International Classification Of Diseases ◽  
Factitious Disorder ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases

Factitious disorder and malingering are two forms of abnormal illness behaviour in which mental or somatic symptoms are deliberately fabricated or grossly exaggerated or otherwise grossly misrepresented. They are forms of other-deceit, with the person in question assumed to be fully aware of this deceit. The central distinguishing feature of both is that factitious disorder is commonly thought to be motivated by internal incentives (primary gain: medical treatment, assuming the sick role), while malingering is directed towards an external goal (secondary gain, for example monetary compensation, sick leave). The utility of distinguishing between the two forms of feigning has long been questioned. Similarly, it must be questioned why factitious disorder is apprehended as a mental disorder in its own right. Neither the Diagnostic and Statistical Manual of Mental Disorders (DSM) nor the International Classification of Diseases (ICD) contains useful diagnostic guidelines for reliably diagnosing feigned illness presentations; in particular, several decades of malingering research and conceptual developments have found no repercussion there.

Towards a new conceptual framework for psychopathology: Embodiment, enactivism, and embedment

2018 ◽  
Vol 28 (6) ◽  
pp. 800-822 ◽  
Author(s):  
Kristopher Nielsen ◽  
Tony Ward
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Conceptual Framework ◽  
Continuous Model ◽  
Research Domain Criteria ◽  
Eliminative Materialism ◽  
The Mind ◽  
Metaphysical Position ◽  
Research Domain

Psychopathology classification is at a conceptual crossroads. It is becoming increasingly accepted that the flaws of the DSM relate to its struggles to pick out “real” entities as opposed to clusters of symptoms. The Research Domain Criteria (RDoC) was formulated in response to this failure, and attempts to address the concerns confronting the DSM by shifting to a causal and continuous model of psychopathology. Noting key criticisms of neurocentricism and problems with conceptual validity leveled at the RDoC, we argue that they stem from its grounding in the metaphysical position of eliminative materialism, or at least material-reductionism. We propose that 3e cognition (viewing the mind as embodied, embedded, and enactive) offers a superior alternative to eliminative materialism. A 3e-informed framework of mental disorder is sketched out and its advantages as a basis for classifying and conceptualizing mental disorders are considered.

Angststörungen – von der ICD-10 zur ICD-11

2020 ◽  
pp. 1-5
Author(s):  
Timo D. Vloet ◽  
Marcel Romanos
Keyword(s):  
Mental Disorders ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Classification Of Diseases ◽  
Icd 10

Zusammenfassung. Hintergrund: Nach 12 Jahren Entwicklung wird die 11. Version der International Classification of Diseases (ICD-11) von der Weltgesundheitsorganisation (WHO) im Januar 2022 in Kraft treten. Methodik: Im Rahmen eines selektiven Übersichtsartikels werden die Veränderungen im Hinblick auf die Klassifikation von Angststörungen von der ICD-10 zur ICD-11 zusammenfassend dargestellt. Ergebnis: Die diagnostischen Kriterien der generalisierten Angststörung, Agoraphobie und spezifischen Phobien werden angepasst. Die ICD-11 wird auf Basis einer Lebenszeitachse neu organisiert, sodass die kindesaltersspezifischen Kategorien der ICD-10 aufgelöst werden. Die Trennungsangststörung und der selektive Mutismus werden damit den „regulären“ Angststörungen zugeordnet und können zukünftig auch im Erwachsenenalter diagnostiziert werden. Neu ist ebenso, dass verschiedene Symptomdimensionen der Angst ohne kategoriale Diagnose verschlüsselt werden können. Diskussion: Die Veränderungen im Bereich der Angsterkrankungen umfassen verschiedene Aspekte und sind in der Gesamtschau nicht unerheblich. Positiv zu bewerten ist die Einführung einer Lebenszeitachse und Parallelisierung mit dem Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Schlussfolgerungen: Die entwicklungsbezogene Neuorganisation in der ICD-11 wird auch eine verstärkte längsschnittliche Betrachtung von Angststörungen in der Klinik sowie Forschung zur Folge haben. Damit rückt insbesondere die Präventionsforschung weiter in den Fokus.

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