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He said he hopes the document, which is due to be published in May 2013, will lead to greater innovation in psychiatric research and practice. “We need find ways of unshackling science that will encourage scientists to ...
Lecturer Hopes DSM-5 Will Lead to Innovation in Research, Practice
For Steven E. Hyman, M.D., one of this year’s APA Distinguished Psychiatrist Lecturers, the upcoming publication of DSM-5 is just a beginning. He said he hopes the document, which is due to be published in May 2013, will lead to greater innovation in psychiatric research and practice.
“We need find ways of unshackling science that will encourage scientists to recluster and create a diagnostic system from the bottom up,” said Dr. Hyman, who will discuss how the DSM-5 will affect the future of psychiatric practice and research at 11 a.m. today in Room 115A-C, Level 1, Pennsylvania Convention Center. His lecture is titled “Can We Safely Deliver the DSM-5 Into the 21st Century?”
One of the expected changes in the DSM-5 is the introduction of dimensional diagnoses, such as within the autism spectrum, which has garnered notice in the popular press. “The science tells us most of the disorders we have are not categories,” Dr. Hyman said. “Fundamentally, the DSM-3 had too many individual categories when, in fact, the world is better represented by dimensions and probably larger grouping.”
The DSM-3, published in 1980, is considered a foundation work that led to significant successes in psychiatric research and clinical practice over the last few decades. But it was based on science of the 1960s and 1970s.
“It is not surprising we are discovering substantial problems with its organization,” said Dr. Hyman, Director of the Stanley Center for Psychiatric Research at the Broad Institute and Harvard University Distinguished Service Professor of Stem Cell and Regenerative Biology. “The core problem that the intellectual forbearers of the DSM-3 couldn’t foresee is the genetic complexity of psychiatric disorders.”
The lack of objective medical tests for the vast majority of disorders listed in the manual led to the creation of operationalized diagnostic criteria. This enhanced interrater reliability and helped psychiatrists agree on diagnoses. But research into the genetic factors of mental disease has made the categorization of mental disorders too simplistic.
“The DSM-3 was a brilliant document that could not have foreseen the science,” Dr. Hyman said. “It’s time to move on scientifically.”
In some ways, the DSM-3 also hindered innovation, Dr. Hyman said. Researchers seeking National Institutes of Health grants or trying to publish in a top journal have to follow DSM criteria. But in some ways, those researchers could never get outside the DSM criteria and look at other ways of classifying psychopathology.
“For example, it was very hard to get a grant to test the hypothesis that maybe the apparent comorbidity of multiple anxiety disorder and mood disorders was just that there was a single underlying process or single disorder that got expressed with different symptom complexes in different times in life, or depending upon different environments or context one lived in,” Dr. Hyman explained.
“We need find ways of unshackling science that will encourage scientists to recluster and create a diagnostic system from the bottom up,” said Dr. Hyman, who will discuss how the DSM-5 will affect the future of psychiatric practice and research at 11 a.m. today in Room 115A-C, Level 1, Pennsylvania Convention Center. His lecture is titled “Can We Safely Deliver the DSM-5 Into the 21st Century?”
One of the expected changes in the DSM-5 is the introduction of dimensional diagnoses, such as within the autism spectrum, which has garnered notice in the popular press. “The science tells us most of the disorders we have are not categories,” Dr. Hyman said. “Fundamentally, the DSM-3 had too many individual categories when, in fact, the world is better represented by dimensions and probably larger grouping.”
The DSM-3, published in 1980, is considered a foundation work that led to significant successes in psychiatric research and clinical practice over the last few decades. But it was based on science of the 1960s and 1970s.
“It is not surprising we are discovering substantial problems with its organization,” said Dr. Hyman, Director of the Stanley Center for Psychiatric Research at the Broad Institute and Harvard University Distinguished Service Professor of Stem Cell and Regenerative Biology. “The core problem that the intellectual forbearers of the DSM-3 couldn’t foresee is the genetic complexity of psychiatric disorders.”
The lack of objective medical tests for the vast majority of disorders listed in the manual led to the creation of operationalized diagnostic criteria. This enhanced interrater reliability and helped psychiatrists agree on diagnoses. But research into the genetic factors of mental disease has made the categorization of mental disorders too simplistic.
“The DSM-3 was a brilliant document that could not have foreseen the science,” Dr. Hyman said. “It’s time to move on scientifically.”
In some ways, the DSM-3 also hindered innovation, Dr. Hyman said. Researchers seeking National Institutes of Health grants or trying to publish in a top journal have to follow DSM criteria. But in some ways, those researchers could never get outside the DSM criteria and look at other ways of classifying psychopathology.
“For example, it was very hard to get a grant to test the hypothesis that maybe the apparent comorbidity of multiple anxiety disorder and mood disorders was just that there was a single underlying process or single disorder that got expressed with different symptom complexes in different times in life, or depending upon different environments or context one lived in,” Dr. Hyman explained.
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