Do we need to replace categorical with dimensional diagnoses to make progress in psychiatry research? No.
The release of Research Domain Criteria (RDoC), which occurred coincident with publication of the DSM-5, has been touted as offering a superior classification system for psychiatric disorders. Its advantage is supposedly based on mechanisms rather than symptoms. Pushback from clinicians and researchers1-3 has led to partial refashioning of RDoC goals, from initial emphasis on improved diagnosis to revised claims of a scientific nosology for clinical research. For any new scheme for patient categorization to be an advance, it has to prove superior on multiple levels to the consensus clinical tactics of DSM-5. We doubt that this will occur with RDoC because it lacks the very scientific foundation that it proclaims. We lay out our “con” argument in homage to Sergio Leone.
Weinberger DR, Glick ID, Klein DF. Whither Research Domain Criteria (RDoC)? The Good, the Bad, and the Ugly. JAMA Psychiatry. 2015;72(12):1161–1162. doi:10.1001/jamapsychiatry.2015.1743
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