Psychiatric Nosology

PURPOSE OF REVIEW: As a part of the its current revision of the International Classification of Diseases (ICD), the WHO is proposing major changes to the somatoform section of the chapter on Mental and Behavioral Disorders. This article reviews the basis for these changes and presents the highlights of the new category being proposed. RECENT FINDINGS: As currently classified in ICD-10, somatoform disorders have major problems that limit their clinical utility. Among these are the negative criterion specifications for the diagnosis of the disorders, the rarity of the prototype categories, and the imprecise boundaries between them...

The well-respected tradition of research on concepts uses cross-cultural comparisons to explore which aspects of conceptual behavior are universal versus culturally variable. This work continues, but it is being supplemented by intensified efforts to study how conceptual systems and cultural systems interact to modify and support each other. For example, cultural studies within the framework of domain specificity (e.g., folkphysics, folkpsychology, folkbiology) are beginning to query the domains themselves and offer alternative organizing principles (e...

Mental disorders represent a significant global burden whose effects are exacerbated by gaps in diagnosis and service provision. A substantial number of individuals seek services not through specialty psychiatric clinics but through primary care. Thus, the interface between psychiatry and the rest of medicine represents an appropriate area of focus in which to improve the detection and treatment of mental disorders. Development of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) can play a key role in this process...

The Diagnostic and Statistical Manual of Mental Disorders (DSM) was created in 1952 by the American Psychiatric Association so that mental health professionals in the United States would have a common language to use when diagnosing individuals with mental disorders. Since the initial publication of the DSM, there have been five subsequent editions of this manual published (including the DSM-III-R). This review discusses the structural changes in the six editions and the research that influenced those changes...

We present a revision of latent state-trait (LST-R) theory with new definitions of states and traits. This theory applies whenever we study the consistency of behavior, its variability, and its change over time. States and traits are defined in terms of probability theory. This allows for a seamless transition from theory to statistical modeling of empirical data. LST-R theory not only gives insights into the nature of latent variables but it also takes into account four fundamental facts: Observations are fallible, they never happen in a situational vacuum, they are always made using a specific method of observations, and there is no person without a past...

The manifold symptoms of depression are common and often transient features of healthy life that are likely to be adaptive in difficult circumstances. It is when these symptoms enter a seemingly self-propelling spiral that the maladaptive features of a disorder emerge. We examine this malignant transformation from the perspective of the computational neuroscience of decision making, investigating how dysfunction of the brain's mechanisms of evaluation might lie at its heart. We start by considering the behavioral implications of pessimistic evaluations of decision variables...

This essay, which seeks to provide an historical framework for our efforts to develop a scientific psychiatric nosology, begins by reviewing the classificatory approaches that arose in the early history of biological taxonomy. Initial attempts at species definition used top-down approaches advocated by experts and based on a few essential features of the organism chosen a priori. This approach was subsequently rejected on both conceptual and practical grounds and replaced by bottom-up approaches making use of a much wider array of features...