Hostname: page-component-55f67697df-xlmdk Total loading time: 0 Render date: 2025-05-23T18:09:47.206Z Has data issue: false hasContentIssue false
  • English
  • Français

Research planning for the future of psychiatric diagnosis

Published online by Cambridge University Press:  15 April 2020

D.A. Regier ,
E.A. Kuhl ,
W.E. Narrow  and
D.J. Kupfer
D.A. Regier*
Affiliation:
American Psychiatric Institute for Research and Education, Division of Research, American Psychiatric Association, 1000 Wilson Boulevard, Suite 1825, Arlington, VA 22209, United States
E.A. Kuhl
Affiliation:
American Psychiatric Institute for Research and Education, Division of Research, American Psychiatric Association, 1000 Wilson Boulevard, Suite 1825, Arlington, VA 22209, United States
W.E. Narrow
Affiliation:
American Psychiatric Institute for Research and Education, Division of Research, American Psychiatric Association, 1000 Wilson Boulevard, Suite 1825, Arlington, VA 22209, United States
D.J. Kupfer
Affiliation:
Western Psychiatric Clinical Institute and the University of Pittsburgh Medical Center, PA 3811 O’Hara Street, Pittsburgh, PA 15213-2593, United States
*
*Corresponding author. Tel.: +703 907 8630; fax: +703 907 1087. E-mail address:dregier@psych.org(D.A. Regier).
Get access

Abstract

More than 10 years prior to the anticipated 2013 publication of DSM-5, processes were set in motion to assess the research and clinical issues that would best inform future diagnostic classification of mental disorders. These efforts intended to identify the clinical and research needs within various populations, examine the current state of the science to determine the empirical evidence for improving criteria within and across disorders, and stimulate research in areas that could potentially provide evidence for change. In the second phase of the revision process, the American Psychiatric Institute for Research and Education (APIRE) recently completed the 5-year international series of 13 diagnostic conferences convened by APA/APIRE in collaboration with the World Health Organization and the National Institutes of Health (NIH), under a cooperative grant funded by the NIH. From these conferences, the DSM-5 Task Force and Work Groups have developed plans for potential revisions for DSM-5, including the incorporation of dimensional approaches within and across diagnostic groups to clarify heterogeneity, improve diagnostic validity, and enhance clinical case conceptualization. Use of dimensions for measurement-based care has been shown to be feasible in psychiatric and primary care settings and may inform monitoring of disorder threshold, severity, and treatment outcomes. The integration of dimensions with diagnostic categories represents an exciting and potentially transformative approach for DSM-5 to simultaneously address DSM-IV's clinical short-comings and create novel pathways for research in neurobiology, genetics, and psychiatric epidemiology.

Keywords

DSM-5ICD-11Psychiatric nosologyClassification of psychiatric disorders
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 7 , October 2012 , pp. 553 - 556
Copyright
Copyright © European Psychiatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd Edition. Washington, DC: American Psychiatric Association; 1980.Google Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd Edition, revised. Washington, DC: American Psychiatric Association; 1987.Google Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th Edition. Washington, DC: American Psychiatric Association; 1994.Google Scholar
Andrews, G.Charney, D.S.Sirovatka, P.J.Regier, D.A.Stress-Induced and Fear Circuitry Disorders: Refining the Research Agenda for DSM-V. Arlington, VA: American Psychiatric Association; 2009.Google Scholar
Boyd, J.H.Burke, J.D. Jr.Gruenberg, E.et al.Exclusion criteria of DSM-III: a study of co-occurrence of hierarchy-free syndromes. Arch Gen Psychiatry. 1984; 41: 983–989.CrossRefGoogle ScholarPubMed
Brown, T.A.Barlow, D.H.Dimensional versus categorical classification of mental disorders in fifth edition of the diagnostic and statistical manual of mental disorders and beyond: comment on the special section [Special Issue]. J Ab Psychol. 2005; 114: 551–556.CrossRefGoogle ScholarPubMed
Duffy, F.F.Chung, H.Trivedi, M.Rae, D.S.Regier, D.A.Katzelnick, D.J.Systematic use of patient-rated depression severity monitoring: is it helpful and feasible in clinical psychiatry?. Psychiatr Serv. 2008; 59: 1148–1154.CrossRefGoogle ScholarPubMed
First, M.B.Spitzer, R.L.Gibbon, M.Williams, J.B.W.Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition (SCID-I/P, version 2.0). New York, NY: Biometrics Research Department, New York State Psychiatric Institute; 1995.Google Scholar
Goldberg, D.Kendler, K.S.Sirovatka, P.J.Regier, D.A.Diagnostic Issues in Depression and Generalized Anxiety Disorder: Refining the Research Agenda for DSM-V. Arlington, VA: American Psychiatric Association; 2010.Google Scholar
Helzer, J.E.Kraemer, H.C.Krueger, R.F.Wittchen, H.U.Sirovatka, P.J.Regier, D.A.Dimensional Approaches in Diagnostic Classification: Refining the Research Agenda for DSM-V. Washington, DC: American Psychiatric Association; 2008.Google Scholar
Hollander, E.Zohar, J.Sirovatka, P.J.Regier, D.A.Obsessive-Compulsive Behavior Spectrum Disorders: Refining the Research Agenda for DSM-V. Arlington, VAAmerican Psychiatric Association 2010.Google Scholar
Kessler, R.C.Merikangas, K.R.Berglund, P.Eaton, W.W.Koretz, D.S.Walters, E.E.Mild disorders should not be eliminated from the DSM-V. Arch Gen Psychiatry. 2003; 60: 1117–1122.CrossRefGoogle Scholar
Kessler, R.C.Chiu, W.T.Demler, O.et al.Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005; 62: 617–627.CrossRefGoogle ScholarPubMed
Kraemer, H.C.DSM categories and dimensions in clinical and research contexts.Helzer, J.E.Kraemer, H.C.Krueger, R.F.Wittchen, H.U.Sirovatka, P.J.Regier, D.A.Dimensional Approaches in Diagnostic Classification: Refining the Research Agenda for DSM-V. Washington, DCAmerican Psychiatric Association 2008 5–18.Google Scholar
Krueger, R.F.Markon, K.E.Reinterpreting comorbidity: a model-based approach to understanding and classifying psychopathology. Annu Rev Clin Psychol. 2006; 2: 111–133.CrossRefGoogle ScholarPubMed
Kupfer, D.J.First, M.B.Regier, D.A.A Research Agenda for the DSM-V. Washington, DC: American Psychiatric Association; 2002.Google Scholar
Kupfer, D.J.Regier, D.A.Kuhl, E.A.On the road to DSM-V and ICD-11. Eur Arch Psychiatry Clin Neurosci. 2008; 258 suppl. 5: 2–6.CrossRefGoogle ScholarPubMed
Narrow, W.E.Rae, D.S.Robins, L.N.Regier, D.A.Revised prevalence estimates of mental disorders in the United States: using a clinical significance criterion to reconcile 2 surveys’ estimates. Arch Gen Psychiatry. 2002; 59: 115–123.CrossRefGoogle ScholarPubMed
Narrow, W.E.First, M.B.Sirovatka, P.J.Regier, D.A.Age and Gender Considerations in Psychiatric Diagnosis: A Research Agenda for DSM-V. Arlington, VA: American Psychiatric Association; 2007.Google Scholar
Peteet, J.R.Lu, F.G.Narrow, W.E.Religious and Spiritual Issues in Psychiatric Diagnosis: A Research Agenda for DSM-5. Arling, VAAmerican Psychiatric Association 2010.Google Scholar
Phillips, K.A.First, M.B.Pincus, H.A.Advancing DSM: Dilemmas in Psychiatric Diagnosis. Washington, DC: American Psychiatric Association; 2003.Google Scholar
Pincus, H.A.Tew, J.D.First, M.B.Psychiatric comorbidity: is more less?. World Psychiatry. 2004; 3: 18–23.Google Scholar
Regier, D.A.Introduction, Part VII Nosologic principles and diagnostic criteria.Tischler, G.L.Diagnosis and Classification in Psychiatry: A Critical Appraisal of DSM-III. New YorkCambridge University Press 1987.Google Scholar
Regier, D.A.Narrow, W.E.Rae, D.S.Letter to the editor. Arch Gen Psychiatry. 2004; 61: 1051–1052.CrossRefGoogle Scholar
Robins, L.N.Using survey results to improve the validity of the standard psychiatric nomenclature. Arch Gen Psychiatry. 2004; 61: 1188–1194.CrossRefGoogle ScholarPubMed
Saunders, J.B.Schuckit, M.A.Sirovatka, P.J.Regier, D.A.Diagnostic Issues in Substance Use Disorders: Refining the Research Agenda for DSM-V. Arlington, VA: American Psychiatric Association; 2007.Google Scholar
Saxena S, Esparza P, Regier DA, Saraceno B, Sartorius N. Public Health Aspects of Diagnosis and Classification of Mental and Behavioural Disorders: Refining the Research Agenda for DSM-5 [In preparation].Google Scholar
Slade, T.Watson, D.The structure of common DSM-IV and ICD-10 mental disorders in the Australian general population. Psycholog Med. 2006; 36: 1593–1600.CrossRefGoogle ScholarPubMed
Spitzer, R.L.Kroenke, K.Williams, J.B.et al.A brief measure for assessing generalised anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166: 1092–1097.CrossRefGoogle Scholar
Sunderland, T.Jeste, D.V.Baiyewu, O.Sirovatka, P.J.Regier, D.A.Diagnostic Issues in Dementia: Advancing the Research Agenda for DSM-V. Arlington, VA: American Psychiatric Association; 2007.Google Scholar
Tamminga, C.A.Sirovatka, P.J.Regier, D.A.van Os, J.Deconstructing Psychosis: Refining the Research Agenda for DSM-V. Arlington VAAmerican Psychiatric Association 2009.Google Scholar
Tew, J.Pincus, H.A.The conundrum of psychiatric comorbidity. Psych Times. 2007; 24(14): 1–2.Google Scholar
Trivedi, M.H.Rush, J.A.Wisniewski, S.R.Nierenberg, A.A.Warden, D.Ritz, L.et al.Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: Implications for clinical practice. Am J Psychiatry. 2006; 163: 28–40.CrossRefGoogle ScholarPubMed
Widiger, T.A.Simonsen, E.Sirovatka, P.J.Regier, D.A.Dimensional Models of Personality Disorders: Refining the Research Agenda for DSM-V. Arlington, VA: American Psychiatric Association; 2006.Google Scholar
Zimmerman, M.Mattia, J.I.Psychiatric diagnosis in clinical practice: is comorbidity being missed?. Compr Psychiatry. 1999; 40: 182–191.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.