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ToolsMcGorry, Patrick D., Hickie, Ian B., Kotov, Roman, Schmaal, Lianne, Wood, Stephen J., Allan, Sophie M., Altınbaş, Kürşat, Boyce, Niall, Bringmann, Laura F., Caspi, Avshalom, Cuthbert, Bruce, Gaweȩda, Łukasz, Groen, Robin N., Guloksuz, Sinan, Hartmann, Jessica A., Krueger, Robert F., Mei, Cristina, Nieman, Dorien, Öngür, Dost, Raballo, Andrea, Scheffer, Marten, Schreuder, Marieke J., Shah, Jai L., Wigman, Johanna T. W., Yuen, Hok Pan and Nelson, Barnaby (2025) New diagnosis in psychiatry: Beyond heuristics. Psychological Medicine, 55. ISSN 0033-2917
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Abstract
Background Diagnosis in psychiatry faces familiar challenges. Validity and utility remain elusive, and confusion regarding the fluid and arbitrary border between mental health and illness is increasing. The mainstream strategy has been conservative and iterative, retaining current nosology until something better emerges. However, this has led to stagnation. New conceptual frameworks are urgently required to catalyze a genuine paradigm shift. Methods We outline candidate strategies that could pave the way for such a paradigm shift. These include the Research Domain Criteria (RDoC), the Hierarchical Taxonomy of Psychopathology (HiTOP), and Clinical Staging, which all promote a blend of dimensional and categorical approaches. Results These alternative still heuristic transdiagnostic models provide varying levels of clinical and research utility. RDoC was intended to provide a framework to reorient research beyond the constraints of DSM. HiTOP began as a nosology derived from statistical methods and is now pursuing clinical utility. Clinical Staging aims to both expand the scope and refine the utility of diagnosis by the inclusion of the dimension of timing. None is yet fit for purpose. Yet they are relatively complementary, and it may be possible for them to operate as an ecosystem. Time will tell whether they have the capacity singly or jointly to deliver a paradigm shift. Conclusions Several heuristic models have been developed that separately or synergistically build infrastructure to enable new transdiagnostic research to define the structure, development, and mechanisms of mental disorders, to guide treatment and better meet the needs of patients, policymakers, and society.
| Item Type: | Article |
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| Additional Information: | Funding statement: PM was supported by a National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship (1155508). BN was supported by a University of Melbourne Dame Kate Campbell Fellowship. SG was supported by the YOUTH-GEMs project, funded by the European Union’s Horizon Europe program under Grant Agreement Number 101057182 and by the Ophelia research project, funded by the ZonMw under Grant 636340001. JLS was supported by a clinician–scientist salary award from the Fonds de Recherche du Québec–Santé. LS was supported by an NHMRC Investigator Grant Leadership 1 (2017962). MS was supported by the European Research Council under the European Union’s Horizon 2020 research and innovative programme (681466). IH was supported by NHMRC Centre for Research Excellence grants (1171910 and 1061043). LB was supported by a Netherlands Organization for Scientific Research Veni Grant (191G.037). RK was partly supported by the following NIH grants: U19AG051426; R01AG05321; R01AG077742–02. The funding source had no role in the writing or publication of the manuscript. |
| Uncontrolled Keywords: | clinical staging,clinical utility,complex systems,network analysis,paradigm shift,psychiatric diagnosis,research domain criteria (rdoc),the hierarchical taxonomy of psychopathology (hitop),applied psychology,psychiatry and mental health,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/3200/3202 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School Faculty of Medicine and Health Sciences > School of Health Sciences |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 15 Jul 2025 09:41 |
| Last Modified: | 15 Jul 2025 09:41 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/99922 |
| DOI: | 10.1017/S003329172400223X |
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