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Post by Former NIMH Director Thomas Insel

Inara

Senior Member
Messages
455
https://www.nimh.nih.gov/about/directors/thomas-insel/index.shtml

"Thomas R. Insel, M.D., was Director of the National Institute of Mental Health (NIMH) from 2002-2015. His tenure at NIMH featured groundbreaking findings in the areas of practical clinical trials, autism research, and the role of genetics in mental illnesses.

During his time at NIMH, Dr. Insel wrote many blog posts. While these posts may no longer represent the current positions of NIMH, we are keeping them available to the public for archival purposes."

https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml

"The weakness is its [DSM V] 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."

"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."

"It became immediately clear that we cannot design a system based on biomarkers or cognitive performance because we lack the data."

"RDoC is nothing less than a plan to transform clinical practice by bringing a new generation of research to inform how we diagnose and treat mental disorders. As two eminent psychiatric geneticists recently concluded, “At the end of the 19th century, it was logical to use a simple diagnostic approach that offered reasonable prognostic validity. At the beginning of the 21st century, we must set our sights higher.”

But note, that his "posts may no longer represent the current positions of NIMH".