I think there is interest, especially since the s***show that was the DSM5 manual...
1. Here's the scathing letter from the (then) head of NIMH, Robert Insell, basically telling the APA (authors of said DSM5) to get their science on....It's a pretty fantastic letter, IMO..
https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml
"The goal of this new manual, as with all previous editions, is to provide a common language for describing psychopathology.
While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever.
Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.
Patients with mental disorders deserve better.
NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system. Through a series of workshops over the past 18 months, we have tried to define several major categories for a new nosology (see below). This approach began with several assumptions:
- A diagnostic approach based on the biology as well as the symptoms must not be constrained by the current DSM categories,
- Mental disorders are biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior,
- Each level of analysis needs to be understood across a dimension of function,
- Mapping the cognitive, circuit, and genetic aspects of mental disorders will yield new and better targets for treatment.
It became immediately clear that we cannot design a system based on biomarkers or cognitive performance because we lack the data. In this sense, RDoC is a framework for collecting the data needed for a new nosology. But it is critical to realize that we cannot succeed if we use DSM categories as the “gold standard.”
2 The diagnostic system has to be based on the emerging research data, not on the current symptom-based categories. Imagine deciding that EKGs were not useful because many patients with chest pain did not have EKG changes. That is what we have been doing for decades when we reject a biomarker because it does not detect a DSM category. We need to begin collecting the genetic, imaging, physiologic, and cognitive data to see how all the data – not just the symptoms – cluster and how these clusters relate to treatment response."
Robert Insell @ Tedx
2. Robert Insell left the NIMH to join Google's life sciences division, Verily. They partnered w a biotech firm (glaxo?) and invested $750m in bio-electric medicine, which, I believe, will include vagus nerve stimulation. The reason that I think that is b/c VNS is indicated as a potential therapy in Parkinson's Disease, and Sergey Brin has the genes for Parkinson's which is why he split from Google, had a mid-life crisis, and started the life sciences division... (extremely truncated explanation!) His wife started 23andme, in part I'm guessing b/c her (then) husband & children have the potential to develop P.D.
tl;dr... I am guessing that Robert Insell is there to explore novel treatments for mental health. Vagus nerve stimulation, and the microbiome bacteria that traverse on the vagus nerve betwixt the brain & gut are a hot topic in the Bay Area (and other places..),
http://www.businessinsider.com/goog...galvani-bioelectronics-glaxosmithkline-2016-8
Psychiatry is a waste basked for doctors who don't know what causes the symptoms of a patiënt. It is like blaming the victim becasue they are mentally incapable to understand everything. Most doctors can't deal with this.
