Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Monday, May 6, 2013

And In This Corner....

Get ready to rumble!

Meet the contender: Thomas Insel, MD of NIMH

And the reigning champion, David Kupfer, MD of the DSM-5

Dr. Insel comes out swinging with the Research Domain Criteria (RDoC), the project launched by NIMH "to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system."

And, wait for it, "..it is critical to realize that we cannot succeed if we use DSM categories as the 'gold standard'...The diagnostic system has to be based on the emerging research data, not on the current symptom-based categories."

Ooooh, low blow.

Now Dr. Kupfer counters with, "Efforts like the National Institute of Mental Health’s Research Domain Criteria (RDoC) are vital to the continued progress of our collective understanding of mental disorders. But they cannot serve us in the here and now, and they cannot supplant DSM-5. RDoC is a complementary endeavor to move us forward, and its results may someday culminate in the genetic and neuroscience breakthroughs that will revolutionize our field. In the meantime, should we merely hand patients another promissory note that something may happen sometime?"

Dr. Insel staggers backward into the ropes. He's covering up with his gloves. But wait, he shoves Dr. Kupfer away and pummels him with, "That is why NIMH will be re-orienting its research away from DSM categories. Going forward, we will be supporting research projects that look across current categories – or sub-divide current categories – to begin to develop a better system."

And Dr. Kupfer is down! The grant money gets 'em every time.

* I hope the Ali-Frazier image is old enough (1974) to be off copyright. If not, I'll promptly remove it, with my apologies.

1 comment:

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