Current concerns in psychiatric diagnostic process and the paradigm shift: Research domain criteria

There are many issues around the current approaches in diagnosing psychiatric illnesses. Most of the diagnoses are symptom-clusters and not etiology based. Although they are reliable constructs, their validity has always been debated. It is a common experience that the presentations of patients having even the same diagnosis vary considerably. Recently following the launch of Diagnostic and Statistical Manual of Mental Disorders-5, concerns have been raised about the possibility of over diagnosis and over-treatment of patients who are essentially well. To address these concerns, there is an initiative to move away from traditional diagnoses and study the clinical phenomena based on behavioral dimensions and neurobiological measures, which will support new ways of classifying mental disorders. Research domain criteria (RDoC) are a framework for collecting the information needed for a new nosology. Conceived as a matrix, RDoC is using different units of analysis to study various domains of functions. Without taking into account current diagnoses, it is trying to find out the abnormalities in different parameters from genes to physiology, circuits etc., in a given clinical presentation. This process will improve the understanding of clinical phenomena in a dimensional model and may ultimately help suggest more appropriate interventions leading to better outcomes for psychiatric disorders