In a new report published in the journal Psychological Science in the Public Interest, a team of scientists delve into the complexities of diagnosing psychiatric disorders.
The authors take an in-depth look at three systems used for understanding mental-health disorders: the International Classification of Diseases (ICD), the Diagnostic and Statistical Manual of Mental Disorders (DSM), and the Research Domain Criteria Project (RDoC).
The report highlights similarities and differences in the ways that the ICD, DSM, and RDoC classify and conceptualize mental disorders, focusing on overarching issues that such systems must confront.
For example, diagnosing mental-health disorders may seem pretty straightforward: Patients discuss their symptoms and a doctor matches those symptoms to a disorder and prescribes an appropriate treatment; in reality, the process is far more complex. According to the researchers, psychological problems tend to arise out of a long, unfolding process.
So while distinct categories allow clinical practitioners to diagnose and treat each disorder, they also limit how we think about individual functioning and outcomes. Rather, mental disorders arise from a complex interplay of genetic, individual, and sociocultural factors, and understanding causal pathways requires taking a nuanced, individualized approach.
“One of the main things that we kept coming back to is the idea that ‘having a mental disorder’ is very different from having the measles or even something like diabetes — and it can be helpful to think about mental disorder psychopathology in this more complex way,” said researcher Lee Anna Clark, Ph.D. “While there definitely are treatments and ways to help people deal with mental disorders, there aren’t any magic bullets.”
Clark authored the new paper with researchers Drs. Bruce Cuthbert, Roberto Lewis-Fernández, William E. Narrow, and Geoffrey M. Reed.
Advances in clinical science over the past several decades have led to major improvements in how mental disorders are diagnosed and treated. But as science reveals more about the origins and development of mental health conditions, more questions are continually raised.
“It’s so tempting to think, ‘If we could only zap out this one gene, schizophrenia would be gone from the world. But my prediction is that as we learn more, things will also be revealed that are even more complex than we can imagine,” said Clark.
“At the same time, there’s no question that we know so much more than we did even 25 years ago. And what we know can get us a very long way toward helping people even if we don’t understand all the little ins and outs.”