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mikassyna
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eric76
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03 May 2013, 1:07 pm

No executive summary?



mikassyna
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03 May 2013, 1:26 pm

eric76 wrote:
No executive summary?

The executive summary is the title of this thread LOL



amyb73
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03 May 2013, 2:02 pm

eric76 wrote:
No executive summary?



Haha! Need a LIKE button!

:D



Fnord
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03 May 2013, 2:23 pm

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In the announcement, NIMH Director Thomas Insel says the DSM lacks validity and that "patients with mental disorders deserve better".

Image

Now what?



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03 May 2013, 4:23 pm

Announced after hours on Friday afternoon 2 weeks prior to DSM-5 release.....something is up here.


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eric76
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03 May 2013, 4:36 pm

I went ahead and read the link. It is about the National Institute of Mental Health (NIMH) moving away from a diagnostic approach and towards a new system of classification.

The link at the bottom is to the actual statement which is, I think, far more explanatory than the article in the link.

From http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml:

Quote:
NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system. Through a series of workshops over the past 18 months, we have tried to define several major categories for a new nosology (see below). This approach began with several assumptions:

* A diagnostic approach based on the biology as well as the symptoms must not be constrained by the current DSM categories,

* Mental disorders are biological disorders involving brain circuits that implicate specific domains of cognition, emotion, or behavior,

* Each level of analysis needs to be understood across a dimension of function,

* Mapping the cognitive, circuit, and genetic aspects of mental disorders will yield new and better targets for treatment.

It became immediately clear that we cannot design a system based on biomarkers or cognitive performance because we lack the data. In this sense, RDoC is a framework for collecting the data needed for a new nosology. But 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. Imagine deciding that EKGs were not useful because many patients with chest pain did not have EKG changes. That is what we have been doing for decades when we reject a biomarker because it does not detect a DSM category. We need to begin collecting the genetic, imaging, physiologic, and cognitive data to see how all the data – not just the symptoms – cluster and how these clusters relate to treatment response.

... 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.

...

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.



Last edited by eric76 on 03 May 2013, 6:18 pm, edited 1 time in total.

Misslizard
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03 May 2013, 5:59 pm

Fnord wrote:
Quote:
In the announcement, NIMH Director Thomas Insel says the DSM lacks validity and that "patients with mental disorders deserve better".

Image

Now what?



One of my favorite paintings.And exactly how I feel about the state of mental health care.
In sick of playing "what's your illness."And you get a new shrink every year who will give you another label. :wall:


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AgentPalpatine
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03 May 2013, 6:15 pm

eric76 wrote:
I went ahead and read the link. It is about the National Institute of Mental Health (NIMH) moving away from a diagnostic approach and towards a new system of classification.

The link at the bottom is to the actual statement which is, I think, far more explanatory than the article in the link.

From http://www.nimh.nih.gov/about/director/ ... osis.shtml:


Could you please correct the link, it has an extra ":" at the end.

The actual blog post was dated Monday, April 29th, but I'm still confused how the story got pushed on Friday afternoon.

I'm not good with medical-speak, but when I see lines like "The weakness is its lack of validity", this looks pretty rough to the DSM. Asperger's got mentioned near the top of the statement as well.

The timing of this could'nt have been worse, really, since every new grant request is going to pay at least lip service to this concept, and only two weeks out from the big changeover.


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eric76
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03 May 2013, 6:20 pm

AgentPalpatine wrote:
eric76 wrote:
I went ahead and read the link. It is about the National Institute of Mental Health (NIMH) moving away from a diagnostic approach and towards a new system of classification.

The link at the bottom is to the actual statement which is, I think, far more explanatory than the article in the link.

From http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml:


Could you please correct the link, it has an extra ":" at the end.


Thanks. Fixed. I didn't put the url tags around the url.

Quote:
The actual blog post was dated Monday, April 29th, but I'm still confused how the story got pushed on Friday afternoon.

I'm not good with medical-speak, but when I see lines like "The weakness is its lack of validity", this looks pretty rough to the DSM. Asperger's got mentioned near the top of the statement as well.

The timing of this could'nt have been worse, really, since every new grant request is going to pay at least lip service to this concept, and only two weeks out from the big changeover.


I think they are saying that it is time to move on from the DSM. As for the postponement from Monday until Friday, sometimes it takes a few days for people to notice news stories.



AgentPalpatine
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03 May 2013, 6:26 pm

eric76 wrote:
I think they are saying that it is time to move on from the DSM. As for the postponement from Monday until Friday, sometimes it takes a few days for people to notice news stories.


I'm not doubting either. I'll have to look at the timing of some of the articles, perhaps the official release went out later.

It's the timing on this that interests me. DSM-5 has been heavily debated for years, and I can't see an organization as closely tuned to the internal and external politics as NIMH (NIH) completely missing the fact that the largest and most controversal change in decades is coming up in two weeks.


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AardvarkGoodSwimmer
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03 May 2013, 7:40 pm

It sounds like it's going to start changing what research projects they fund.

And clinical practice only down the road depending on what new information is found. (and for depression, for example, it would be nice if a doctor had something to go on regarding whether zoloft is likely to work for a particular patient or not. Currently, it's trial and error in a respectful sense.)

Quote:

CBS News, May 3, 2013

http://alturl.com/44gv3 <--- short url to mobile link

" . . . The decade-long project will require researchers to include patients across DSM categories, or to subdivide the categories, . . "



eric76
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04 May 2013, 4:17 am

mikassyna wrote:
eric76 wrote:
No executive summary?

The executive summary is the title of this thread LOL


Now that is really funny.



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04 May 2013, 5:36 am

It is about time! The DSM lacks Inturnal Boundries,

Possession by Sprites, cannot be seperated from infestion by Elementals!

The Government still gets the bill for Holy Water, for services rendered that could not all be true.

Comparing Psychobabblist to Psychobabbelist, they seem to live, each in a Universe of their own, with no acountability.

The one study done, medical students being called mental convicts, all were continued as mental convicts through the system, with their disorders confirmed by people from across the room, or who never saw them.

In the 1974 case, The Supreme Court said release all the Mental Detaineees, that have never done anything to cause a lack of freedom, and their case was based on their sister saying they were strange.

The Court found there was never a Legal or Medical basis for locking people up for life.

The best Treatment of the time involved Ice Water Baths, Electroshock, Massive doses of Thorizine, and experimental uses of drugs like LSD. Considering the inmate had started treatment for a stutter, The Court found a Lack of Sanity in the Mental Health System.

Twenty years later they were busted in the largest ever Drug Bust, where Psychobabblists were getting cash kickbacks for writing the right perscriptions, for off label use. New and expensive drugs were the first choice, replacing Asprin.

The DSM could never meet the Legal and Medical Standards for Evidence.

They do not define their terms, have no method to classify and group conditions, and present untestable views. Compared, The Four Humors were Hard Science.

The present, mental conditions are side effects of; A, Toxic Exposure, B Trama, C Genetic, and are symptoms of an underlying condition, not a stand alone condition.

As Comics have long showed, a person being hit sees stars, they do not have Steller Dillusion Image Disorder. More important, the stars go away, SDID is considered a lifetime disorder.

The disconnect is obvious, when a person claimed to be a mental case dies, and Toxicology shows they had been poisoned over years by a family member.

Broad Blood Testing, DNA Profile, would bring some order to Causes.

Psychobabble has been treating Conditions without causes. There is some serious doubt the Conditions exist.

Psychobabble is based on the Foundation of, Billable Hours, + Research Grants.

Recent work in other fields, Twin Studies in Genetics, Toxic Materials, Tramatic Brain Injury, account for the symptoms passed off as causes in the DSM.

To abandon the DSM is to step away from Psycho-Fraud, Massive Mal Practice, and Witch Doctors fronting for Drug Company Reps.

An Imaginary Science, treating Imaginary Disorders, for their Imaginary Friend in the sky.

Not only does Genetics give a better view, it, like the Meyers Briggs, shows a range of normal human behavior, and all of the Myers-Briggs threads on WP show a close grouping in one quadrent, that accounts for the 3% of the population with those long known traits.

The NIMH move shows one thing, the evidence is in, Psychology is a Fraud.

A Shout Out to the Troops, where tens of thousands suffered TBI, and Psychology threw the book at them. Ten Shrinks, Ten Dxs. Healthy troops, all suffering from concussion, do not need to support the Drug Industry.

Where Psychology could have done some good, spotting the Islamic shooters, it turned out they were the Islamic shooter at the base in Texas.

Psychology is the study of the most perfect Mind Of God, and how all fall short of the Glory. As such it might be a Religion.

As the largest supplier of legal drugs being misused, they should be shut down. MDs can cover the real drug need.

NIMH you have my support!



Dillogic
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04 May 2013, 12:46 pm

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... DSM lacks validity and that “patients with mental disorders deserve better”.


OCD and Autism fit me well enough as they're written (diagnosed there), and I don't think I "deserve better" than that. It works well.



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04 May 2013, 3:41 pm

One word: Ouch.

Well-deserved, though. Psychiatry really needs to focus more on etiology...