Psychiatric Diagnoses: Current State and Methodological Issues

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About this Research Topic

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Background

Lack of consensus about diagnoses has plagued psychiatry for decades, and efforts to improve the reliability and validity 0f diagnoses have unfortunately not led to major advances. The operational criteria introduced with the DSM-III in 1980 and adapted in ICD-10 in 1992 did not fulfill the promise of significant advances in etiological and therapeutic knowledge of mental disorders. In this deadlock, alternative approaches have been suggested. For example, dimensional approaches to classifying mental disorders, e.g., Research Domain Criteria (RDoC) or Hierarchical Taxonomy of Psychopathology (HiToP), have been put forth as an alternative to the conventional categorical diagnoses. Another line of research, by contrast, points to the importance of diagnostic categories and suggests an approach based on diagnostic prototypes. These nosological questions are intrinsically bound to a range of fundamental issues in psychiatry that contribute to the current differential diagnostic confusions—these include questions about the appropriate methodology for assessing psychopathology, a lack of conceptual clarity of many psychopathological phenomena, and a general decline in knowledge of psychopathology during the last decades. Issues around methodology comprise basic epistemological and ontological questions (realism vs pragmatism), assessment of the very concepts of validity and reliability in the context of psychiatry and psychopathology, and the appropriate procedures to obtain these data (interviews, scales and questionnaires, behavioral tasks, laboratory studies, physiological measures, brain scans, digital phenotyping, and/or other).
This Research Topic aims to provide a forum for studies investigating the difficulties and potential ways forward in psychiatric diagnosing. Recognizing that this topic can be broached from multiple different angles, we seek perspectives and insights from a wide range of disciplines:
(1) Psychiatry (e.g., clinical research addressing issues related to the classification of psychopathologic symptoms and/or disease)(2) Philosophy (e.g., the philosophy of science) (3) Neuroscience (e.g., studies utilizing neurophysiology, neuroimaging, and/or other methods from neuroscience to address issues related to psychiatric diagnosis)(4) Computer science (e.g., machine learning to classify patients based on psychopathologic, neurobiological, or other features)(5) Anthropology; and other relevant disciplines that may not be mentioned here.
We welcome original research (using quantitative as well as qualitative methods), reviews, and theoretical contributions.

Keywords: Diagnosis, Methodology, Psychopathology, Nosology, Prototype, Dimensional

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