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A new meta-structure of mental disorders: a helpful step into the future or a harmful step back to the past?

Aus der Einleitung:

"The authors of the seven meta-structure papers in this issue have to be applauded for their inspiring attempt to suggest and elaborate a new meta-structure of mental disorders consisting of five ‘ clusters ’. At first sight this proposal seems to be considerably simpler than the current diagnostic classifications structure used by DSM-IV-TR (17 categories ; APA, 2000) and, in some parts, more convergent with the ICD-10 (10 categories ; WHO, 1993). Against the background of dissatisfaction expressed with the current diagnostic classification structure for mental disorders and its principles, the authors provide a selective critical review of relevant research. In particular, evidence is examined to address the question of whether current individual mental disorders differ sufficiently from each other and whether the current more fine-graded distinction of specific mental disorders and their grouping in 10 major classes according to ICD-10 and 17 in DSM-IV-TR is justified. To help answer this question, a prioricriteria were chosen in the form of a wide range of ‘validators ’ grouped into so-called ‘causal’ risk factors (i.e. shared genetic risk factors, familiality, shared environmental risks, shared neural substrates, shared biomarkers, shared temperamental antecedents) and factors thought to be more likely to reflect the clinical picture itself (shared abnormalities of cognitive and emotional processing, symptom similarity, rates of co-morbidity, course, treatment response). The results of this impressive exploration are interpreted to suggest a substantial reduction of the current major classes to five clusters and a fairly large residual category of disorders not yet assigned. Particularly noteworthy examples for classificatory changes associated with the proposed meta-structure involve: the suggestion to group anxiety, somatoform and depressive disorders together under the term ‘emotional disorders ’ ; the allocation of bipolar disorders to the ‘psychotic cluster ’ ; and the formation of a broad externalizing cluster that comprises substance use disorders, some of the personality disorders and impulse control disorders. [...]"

Identiferoai:union.ndltd.org:DRESDEN/oai:qucosa.de:bsz:14-qucosa-103723
Date29 January 2013
CreatorsWittchen, Hans-Ulrich, Beesdo, Katja, Gloster, Andrew T.
ContributorsCambridge University Press,
PublisherSaechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden
Source SetsHochschulschriftenserver (HSSS) der SLUB Dresden
LanguageEnglish
Detected LanguageEnglish
Typedoc-type:article
Formatapplication/pdf
SourcePsychological Medicine, Bd. 39 (2009), Nr. 12, S. 2083-2089, ISSN: 0033-2917

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