A New Approach to Diagnosis

Getting Beyond the Limits of Diagnostic Categories

Rich Simon


Darrel Regier, vice chair of the DSM-5 Task Force and director of the APA’s research division, argues that DSM-5 is less about assessing fixed characteristics in clients than it is about guiding clinicians to think more dimensionally about diagnosis. “Everyone who’s had to deal with the clinical reality of patients realizes that they don’t come in neat little packages,” he says in a recent Networker interview. “However, it’s still important to know that there’s a difference between bipolar disorder and schizophrenia, and there’s a difference in how you should treat them.”

In this brief video clip, Regier addresses the question of whether DSM categories can ever fully reflect the almost unimaginable complexity of human nature. “The best analogy I know for what we we’re trying to do in DSM-5 was put forth by the famous psychiatrist Emil Kraepelin,” says Regier. “Rather than a collection of separate diagnoses, he said that we need to think of a diagnostic system as being like a pipe organ, a complex instrument, comprised of different pipes with distinct registers. Think of all those organ pipes as genetic vulnerabilities, all interacting with each other as the organist pulls on the other stops. I think this is a way of thinking about diagnosis that’s different than thinking only about the diagnostic system as a collection of discreet conditions.”

In the Networker Webcast series The Uproar Over DSM-5, Regier goes on to detail how a more dimensional approach to diagnosis can clarify the goals and challenges of treatment.

The Uproar Over DSM-5
How to Use the New Standards with Confidence

Click here for full course details

Topic: Business of Therapy

Tags: bipolar | bipolar disorder | Darrel Regier | diagnosing | Diagnostic and Statistical Manual | diagnostic criteria | diagnostic system | DSM | dsm-5 | psychiatrist | schizophrenia

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1 Comment

Thursday, June 19, 2014 9:54:53 PM | posted by daisy swadesh
I'm glad to hear that DSM-5 heads are thinking about relational problems.
Human babies have, by far, the greatest level of post-natal brain development of all species, allowing them to learn and adapt to the culture into which they were born.
Secure attachment is the greatest guarantee against mental illness and a determinator of healthy social and emotional development..