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Published in: BMC Medicine 1/2013

Open Access 01-12-2013 | Debate

Clinical classification in mental health at the cross-roads: which direction next?

Authors: Ian B Hickie, Jan Scott, Daniel F Hermens, Elizabeth M Scott, Sharon L Naismith, Adam J Guastella, Nick Glozier, Patrick D McGorry

Published in: BMC Medicine | Issue 1/2013

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Abstract

Background

After 30 years of consensus-derived diagnostic categories in mental health, it is time to head in new directions. Those categories placed great emphasis on enhanced reliability and the capacity to identify them via standardized checklists. Although this enhanced epidemiology and health services planning, it failed to link broad diagnostic groupings to underlying pathophysiology or specific treatment response.

Discussion

It is time to adopt new goals that prioritize the validation of clinical entities and foster alternative strategies to support those goals. The value of new dimensions (notably clinical staging), that are both clinically relevant and directly related to emerging developmental and neurobiological research, is proposed. A strong emphasis on ‘reverse translation’ (that is, working back from the clinic to the laboratory) underpins these novel approaches. However, it relies on using diagnostic groupings that already have strong evidence of links to specific risk factors or patterns of treatment response.

Summary

The strategies described abandon the historical divides between clinical neurology, psychiatry and psychology and adopt the promotion of pathways to illness models.
Appendix
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Metadata
Title
Clinical classification in mental health at the cross-roads: which direction next?
Authors
Ian B Hickie
Jan Scott
Daniel F Hermens
Elizabeth M Scott
Sharon L Naismith
Adam J Guastella
Nick Glozier
Patrick D McGorry
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2013
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-11-125

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