Why The U.S. National Institute Of Mental Health Plans To Abandon The DSM

The U.S. National Institute of Mental Health is turning its back on the so-called bible of its field. In a statement, the institute said it will start doing research in a way that ignores the categories in the Diagnostic and Statistical Manual of Mental Disorders, which is commonly known as the “DSM,” plus a number to indicate the edition. This just weeks before the American Psychiatric Association plans to publish the fifth (and controversial) edition of the DSM.

Instead of diagnosing patients based on symptoms such as depressed mood and fatigue, the institute wants to use more quantitative data, such as genetic or brain-imaging data, in diagnoses. Such a shift would bring mental health diagnoses to par with diagnoses in other health fields, according to the institute’s statement. Most other fields abandoned symptom-based diagnosis after the middle of the last century, but not psychiatry. After all, some of the proposed lab measures for mental health, such as genetics and brain images, weren’t even measurable until recently. It took technology a while to catch up to the kinds of data that may be associated with mental health disorders.

“We are committed to new and better treatments, but we feel this will only happen by developing a more precise diagnostic system,” institute director Thomas Insel said in the statement.

The change will affect researchers the most, as they may have to structure their studies differently to get National Institute of Mental Health funding and view their work in a different way. A decade or more down the line, however, it may mean more precise diagnoses and better treatments for patients.

For now, Insel said, psychiatrists will continue to give their patients diagnoses based on the DSM because there’s not enough research yet on what they could use instead.