Deconstructing Psychosis: Refining the Research Agenda for DSM-V

by Carol A. Tamminga MD, Paul J. Sirovatka MS, Darrel A. Regier MD MPH, Jim van van Os MD PhD

Overview

Deconstructing Psychosis: Refining the Research Agenda for DSM-V provides an all-important summary of the latest research about the diagnosis and pathophysiology of psychosis. This volume gives the reader an inside look at how psychotic phenomena are represented in the current diagnostic system and how DSM-V might better address the needs of patients with such disorders.

The book presents a selection of papers reporting the proceedings of a conference titled "Deconstructing Psychosis" convened by the American Psychiatric Association (APA) in collaboration with the World Health Organization (WHO) and the U.S. National Institutes of Health (NIH). The conference was designed to be a key element in the multiphase research review process for the fifth revision of DSM. This book is one in a series of ten that reflects some of the most current and critical examinations of psychiatric disorders and psychotic syndromes. APA published the fourth edition of DSM in 1994 and a text revision in 2000. DSM-V is scheduled for publication in 2013.

Deconstructing Psychosis: Refining the Research Agenda for DSM-V examines the current evidence regarding the diagnosis and pathophysiology of common psychotic syndromes including: • Schizophrenia• Bipolar disorder• Major depressive psychosis• Substance-induced psychosis

It also addresses broad issues relating to diagnosis such as the ways in which psychosis cuts across multiple diagnostic categories. Beyond merely summarizing the current state of the science, the authors of these papers critique the current research and clinical evidence, and raise questions about gaps in our knowledge.

The book provides recommendations for the most promising areas of research in psychosis, which may lead to more refined treatments based on a better understanding of what biological and environmental factors contribute to its development and symptoms.

In the learned editors' selection of papers for inclusion in this volume, they have exhibited their conviction that DSM-V is a "living document" that will reflect the pace of progress in multiple areas, ranging from molecular genetics and brain imaging to social, behavioral, and anthropological science.

As a book on the narrowly defined topic of linking the classification of psychotic syndromes with their underlying pathophysiology and potential etiology, there is no other writing of comparable content available today.

Product Details

ISBN-13:	9780890426531
Publisher:	American Psychiatric Association Publishing
Publication date:	08/11/2009
Pages:	202
Product dimensions:	5.90(w) x 8.90(h) x 0.60(d)
Age Range:	18 Years

About the Author

Carol A. Tamminga, M.D., is a Professor of Psychiatry and Interim Chair of the Department of Psychiatry at the University of Texas Southwestern Medical Center in Dallas, Texas.

Paul J. Sirovatka, M.S., (1947-2007), was Director of Research Policy Analysis at the Division of Research and American Psychiatric Institute for Research and Education at the American Psychiatric Association.

Darrel A. Regier, M.D., M.P.H., is Executive Director of the American Psychiatric Institute for Research and Education and Director of the Division of Research at the American Psychiatric Association in Arlington, Virginia.

Jim van Os, M.D., Ph.D., is a Professor of Psychiatric Epidemiology in the Department of Psychiatry and Neuropsychology at the South Limburg Mental Health Research and Teaching Network, European Graduate School for Neuroscience at Maastricht University in Maastricht, The Netherlands; and Visiting Professor of Psychiatric Epidemiology in the Division of Psychological Medicine at the Institute of Psychiatry in London, England.

Table of Contents

CONTRIBUTORSDISCLOSURE STATEMENTFOREWORD: Rethinking Psychosis in DSM-VINTRODUCTIONChapter 1. DECONSTRUCTING PSYCHOSIS CONFERENCE FEBRUARY 2006: The Validity of Schizophrenia and Alternative Approaches to the Classification of PsychosisChapter 2. BIOLOGICAL, LIFE COURSE, AND CROSS-CULTURAL STUDIES ALL POINT TOWARD THE VALUE OF DIMENSIONAL AND DEVELOPMENTAL RATINGS IN THE CLASSIFICATION OF PSYCHOSISChapter 3. CURRENT ISSUES IN THE CLASSIFICATION OF PSYCHOTIC MAJOR DEPRESSIONChapter 4. DECONSTRUCTING BIPOLAR DISORDER: A Critical Review of Its Diagnostic Validity and a Proposal for DSM-V and ICD-1Chapter 5. DSM-V RESEARCH AGENDA: Substance Abuse/Psychosis ComorbidityChapter 6. THE GENETIC DECONSTRUCTION OF PSYCHOSISChapter 7. HOW SHOULD DSM-V CRITERIA FOR SCHIZOPHRENIA INCLUDE COGNITIVE IMPAIRMENT? Chapter 8. SEARCHING FOR UNIQUE ENDOPHENOTYPES FOR SCHIZOPHRENIA AND BIPOLAR DISORDER WITHIN NEURAL CIRCUITS AND THEIR MOLECULAR REGULATORY MECHANISMSChapter 9. DECONSTRUCTING PSYCHOSIS WITH HUMAN BRAIN IMAGINGChapter 10. IDENTIFYING FUNCTIONAL NEUROIMAGING BIOMARKERS OF BIPOLAR DISORDER: Toward DSM-VChapter 11. THE NEUROPHARMACOLOGY OF PSYCHOSISINDEX

What People are Saying About This

William T. Carpenter Jr.

If a paradigm shift is accomplished with DSM-V, it will be based on identifying meaningful pathological domains within syndromes. This book, with a terrific group of authors, provides the basis for deconstructing psychotic syndromes.

Susan K. Schultz

Shining new light on our traditional diagnostic framework for psychotic disorders, this collection of papers brings together authoritative and incisive views from around the globe. Deconstructing Psychosis represents just one step in the long path of DSM-V deliberations that began over a decade ago. This path may lead to greater validity of our diagnostic constructs through careful development of complementary categorical and dimensional representations of psychotic disorders as well as the integration of emerging knowledge from areas such as genetics, neuroimaging and cognitive neuroscience.

Editorial Reviews

Reviewer: Michael Schrift, DO (University of Washington School of Medicine)
Description: This is an interesting new book covering the difficult problems of the validity of the DSM categories in general and in psychotic disorders classification in particular. The DSM since DSM-III has certainly improved the reliability of the categories, but unfortunately psychiatry has made little headway in the validation of the DSM categories. The DSM categories have been analogous to the classification of animal and plants prior to Darwin, which is to say, they are not biologically based classifications. Classification based on mainly description is prone to error - a whale may be classified as a fish, or edema (dropsy) thought of as a single disease. This book, which grew out of a conference entitled "Future of Psychiatric Diagnosis: Refining the Research Agenda" held in Arlington, VA, in 2006, summarizes the contemporary research on psychosis. The book was written and edited by researchers in the field and adds important ideas to the current conceptualization of psychiatric illnesses.
Purpose: The purpose is to describe the way psychiatric phenomena are currently represented and how DSM-V might help improve diagnostic validity.
Audience: The intended audience includes "psychiatrists, psychologists, and other clinicians and researchers striving to bring symptom relief to patients."
Features: Topics include a general discussion of the validity of schizophrenia; biological, life course, and cross-cultural studies in regards to dimensional and developmental ratings; issues of classification of psychotic major depression; classification of mood disorders; substance abuse and psychosis comorbidity; genetic markers; cognitive impairment as a classifier; the search for endophenotypes in psychotic disorders; brain imaging and classification; and differential neuropharmacological responses as a means for classification. Each chapter concludes with relevant and contemporary citations of the scientific literature.
Assessment: This book presents important summaries of the current state of the validity of the DSM classification of psychotic disorders. Unfortunately, most of these ideas have not been widely disseminated among mental health practitioners with the continued misconception that the DSM represents "nature carved at its joints." This book makes it clear that we are far from a Darwinian paradigm shift in psychiatry.

Doody's Review Service

"If a paradigm shift is accomplished with DSM-V, it will be based on identifying meaningful pathological domains within syndromes. This book, with a terrific group of authors, provides the basis for deconstructing psychotic syndromes."-- "William T. Carpenter Jr., M.D., Professor of Psychiatry and Pharmacology, University of Maryland School of Medicine, Director of Maryland Psychiatric Research Center"

"Shining new light on our traditional diagnostic framework for psychotic disorders, this collection of papers brings together authoritative and incisive views from around the globe. "Deconstructing Psychosis" represents just one step in the long path of DSM-V deliberations that began over a decade ago. This path may lead to greater validity of our diagnostic constructs through careful development of complementary categorical and dimensional representations of psychotic disorders as well as the integration of emerging knowledge from areas such as genetics, neuroimaging and cognitive neuroscience."-- "Susan K. Schultz, M.D., University of Iowa Carver College of Medicine, Iowa City, Iowa"

From the Publisher

Reviewer:Michael Joel Schrift, D.O., M.A.(University of Illinois at Chicago College of Medicine)
Description:This is an interesting new book covering the difficult problems of the validity of the DSM categories in general and in psychotic disorders classification in particular. The DSM since DSM-III has certainly improved the reliability of the categories, but unfortunately psychiatry has made little headway in the validation of the DSM categories. The DSM categories have been analogous to the classification of animal and plants prior to Darwin, which is to say, they are not biologically based classifications. Classification based on mainly description is prone to error - a whale may be classified as a fish, or edema (dropsy) thought of as a single disease. This book, which grew out of a conference entitled "Future of Psychiatric Diagnosis: Refining the Research Agenda" held in Arlington, VA, in 2006, summarizes the contemporary research on psychosis. The book was written and edited by researchers in the field and adds important ideas to the current conceptualization of psychiatric illnesses.
Purpose:The purpose is to describe the way psychiatric phenomena are currently represented and how DSM-V might help improve diagnostic validity.
Audience:The intended audience includes "psychiatrists, psychologists, and other clinicians and researchers striving to bring symptom relief to patients."
Features:Topics include a general discussion of the validity of schizophrenia; biological, life course, and cross-cultural studies in regards to dimensional and developmental ratings; issues of classification of psychotic major depression; classification of mood disorders; substance abuse and psychosis comorbidity; genetic markers; cognitive impairment as a classifier; the search for endophenotypes in psychotic disorders; brain imaging and classification; and differential neuropharmacological responses as a means for classification. Each chapter concludes with relevant and contemporary citations of the scientific literature.
Assessment:This book presents important summaries of the current state of the validity of the DSM classification of psychotic disorders. Unfortunately, most of these ideas have not been widely disseminated among mental health practitioners with the continued misconception that the DSM represents "nature carved at its joints." This book makes it clear that we are far from a Darwinian paradigm shift in psychiatry.