S Nassir Ghaemi1,2, Jules Angst3, Paul A Vohringer4,5, Eric A Youngstrom6, James Phelps7, Philip B Mitchell8, Roger S McIntyre9, Michael Bauer10, Eduard Vieta11, Samuel Gershon12. 1. Department of Psychiatry, Tufts University, 800 Washington St, Boston, MA, 02111, USA. Nassir.ghaemi@tufts.edu. 2. Department of Psychiatry, Harvard Medical School, Boston, USA. Nassir.ghaemi@tufts.edu. 3. Zurich University, Zurich, Switzerland. 4. Department of Psychiatry, Tufts University, 800 Washington St, Boston, MA, 02111, USA. 5. Department of Psychiatry, University of Chile, Santiago, Chile. 6. Departments of Psychology, Neuroscience, and Psychiatry, University of North Carolina, Chapel Hill, NC, USA. 7. Department of Psychiatry, Good Samaritan Regional Medical Center, Corvallis, OR, USA. 8. Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia. 9. Department of Psychiatry, University of Toronto, Toronto, Canada. 10. Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany. 11. Department of Psychiatry and Psychology, Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. 12. Department of Psychiatry, University of Miami, Miami, USA.
Abstract
BACKGROUND: In the 1970 s, scientific research on psychiatric nosology was summarized in Research Diagnostic Criteria (RDC), based solely on empirical data, an important source for the third revision of the official nomenclature of the American Psychiatric Association in 1980, the Diagnostic and Statistical Manual, Third Edition (DSM-III). The intervening years, especially with the fourth edition in 1994, saw a shift to a more overtly "pragmatic" approach to diagnostic definitions, which were constructed for many purposes, with research evidence being only one consideration. The latest editions have been criticized as failing to be useful for research. Biological and clinical research rests on the validity of diagnostic definitions that are supported by firm empirical foundations, but critics note that DSM criteria have failed to prioritize research data in favor of "pragmatic" considerations. RESULTS: Based on prior work of the International Society for Bipolar Diagnostic Guidelines Task Force, we propose here Clinical Research Diagnostic Criteria for Bipolar Illness (CRDC-BP) for use in research studies, with the hope that these criteria may lead to further refinement of diagnostic definitions for other major mental illnesses in the future. New proposals are provided for mixed states, mood temperaments, and duration of episodes. CONCLUSIONS: A new CRDC could provide guidance toward an empirically-based, scientific psychiatric nosology, and provide an alternative clinical diagnostic approach to the DSM system.
BACKGROUND: In the 1970 s, scientific research on psychiatric nosology was summarized in Research Diagnostic Criteria (RDC), based solely on empirical data, an important source for the third revision of the official nomenclature of the American Psychiatric Association in 1980, the Diagnostic and Statistical Manual, Third Edition (DSM-III). The intervening years, especially with the fourth edition in 1994, saw a shift to a more overtly "pragmatic" approach to diagnostic definitions, which were constructed for many purposes, with research evidence being only one consideration. The latest editions have been criticized as failing to be useful for research. Biological and clinical research rests on the validity of diagnostic definitions that are supported by firm empirical foundations, but critics note that DSM criteria have failed to prioritize research data in favor of "pragmatic" considerations. RESULTS: Based on prior work of the International Society for Bipolar Diagnostic Guidelines Task Force, we propose here Clinical Research Diagnostic Criteria for Bipolar Illness (CRDC-BP) for use in research studies, with the hope that these criteria may lead to further refinement of diagnostic definitions for other major mental illnesses in the future. New proposals are provided for mixed states, mood temperaments, and duration of episodes. CONCLUSIONS: A new CRDC could provide guidance toward an empirically-based, scientific psychiatric nosology, and provide an alternative clinical diagnostic approach to the DSM system.
Authors: H S Akiskal; G F Placidi; I Maremmani; S Signoretta; A Liguori; R Gervasi; G Mallya; V R Puzantian Journal: J Affect Disord Date: 1998-10 Impact factor: 4.839