In a few weeks, the American Psychiatric Association will release its new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-IV was released in 1990. The DSM is used by virtually everyone who works in the field of psychiatry to diagnose mental illness. About one week ago, Thomas Insel, the Director of the National Institute of Mental Health released a statement titled Transforming Diagnosis, in which he describes various problems with the way the DSM is used to diagnose mental illness. Insel states, “DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. Their weakness is their lack of validity.” Insel goes on to describe how mental illnesses are still defined and diagnosed according to agreed upon clusters of symptoms, (i.e. auditory hallucinations, visual hallucinations, delusions, paranoia, etc… for schizophrenia) rather than according to an objective laboratory measure. He compares this to diagnosing and treating a patient based on the “nature of their chest pain” or the “quality of their fever”. In Insel’s statement, he describes a new NIMH project called the Research Domain Criteria (RoDC) that aims to create a new classification system for mental illnesses based partly on genetics, imaging, and cognitive science. Although this is a decade-long project that is just beginning, Insel believes that patients and families will benefit from this shift in defining and diagnosing mental illnesses, as it is a step toward “precision medicine”, the movement that has transformed cancer diagnosis and treatment.
On Tuesday, May 14th, we will be discussing the use of brain, cognitive and genomic data to identify and treat mental illness with Dr. Fallahpour. Dr. Fallahpour is currently helping develop one of the largest databases of brain, cognitive, and genomic data across mental disorders, and his work uses a personalized approach in the diagnosis and treatment of neuropsychological disorders. We will also be discussing how this type of data can be used to better help those suffering from mental illness. Please join us next Tuesday!