Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health’s Research Domain Criteria (RDoC)

  title={Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health’s Research Domain Criteria (RDoC)},
  author={Lee Anna Clark and Bruce N. Cuthbert and Roberto Lewis‐Fern{\'a}ndez and William Narrow and Geoffrey M. Reed},
  journal={Psychological Science in the Public Interest},
  pages={145 - 72}
  • L. Clark, B. Cuthbert, G. Reed
  • Published 1 November 2017
  • Psychology, Medicine
  • Psychological Science in the Public Interest
The diagnosis of mental disorder initially appears relatively straightforward: Patients present with symptoms or visible signs of illness; health professionals make diagnoses based primarily on these symptoms and signs; and they prescribe medication, psychotherapy, or both, accordingly. However, despite a dramatic expansion of knowledge about mental disorders during the past half century, understanding of their components and processes remains rudimentary. We provide histories and descriptions… 

Figures and Tables from this paper

The biological classification of mental disorders (BeCOME) study: a protocol for an observational deep-phenotyping study for the identification of biological subtypes
BeCOME has the potential to contribute to a novel taxonomy of mental disorders that integrates the underlying pathomechanisms into diagnoses and will serve as better treatment targets than purely symptom-based disease entities, and help in tailoring the right treatment to the individual patient suffering from a mental disorder.
Clinical utility of ICD‐11 diagnostic guidelines for high‐burden mental disorders: results from mental health settings in 13 countries
The clinical utility of the diagnostic guidelines for ICD‐11 mental, behavioural and neurodevelopmental disorders as assessed by 339 clinicians in 1,806 patients in 28 mental health settings in 13 countries is reported.
Poor Separation of Clinical Symptom Profiles by DSM-5 Disorder Criteria
A quantitative analysis of the symptom heterogeneity and disorder comorbidity across a sample of 107,349 adult individuals from 8 English-speaking countries shows that DSM-5 disorder criteria do not separate individuals from random when the complete mental health symptom profile of an individual is considered.
Bipolar II Disorder Is NOT a Myth
  • A. Nierenberg
  • Psychology
    Canadian journal of psychiatry. Revue canadienne de psychiatrie
  • 2019
Bipolar disorder should be considered as a spectrum and as distinct categories depending on the purpose, be it exploring pathophysiology, longitudinal course, or response to treatment, as well as being folded into a spectrum of bipolar disorder rather than a categorical difference.
The Classification of Mental Disorders: Dual Diagnosis in Persons with Intellectual Disabilities
This chapter explores the evolution of the major diagnostic systems for mental disorders – the APA DSM, the WHO ICD, the NIMH Research Domain Criteria (RDoC), the National Association for the Dually
ICD-11 Revision of Mental Disorders: the Global Standard for Health Data, Clinical Documentation, and Statistical Aggregation
The ICD-11 was the end product of the most extensive global, multilingual, multidisciplinary and participative process ever undertaken for this task, involving more than 15,000 experts from 155 countries, representing approximately 80% of the world’s population.
Engagement of Russian Mental Health Professionals in the Development of WHO’s ICD-11
This paper systematically highlights the substantive roles played by Russian clinicians in all steps of development of the mental, behavioural, and neurodevelopmental disorder guidelines, including their participation in early formative field studies that informed the organizing principles and overarching structure of the ICD-11.
The Heterogeneity of Mental Health Assessment
There is substantial inconsistency in the inclusion and emphasis of symptoms assessed within disorders as well as considerable symptom overlap across disorder-specific tools, demonstrating the need for standardized assessment tools that are more disorder agnostic and span the full spectrum of mental health symptoms.
Changes from ICD-10 to ICD-11 and future directions in psychiatric classification

To meet the needs of different user groups, it is proposed to expand the stepwise approach to diagnosis introduced for some diagnostic categories in ICD-11, which includes categorical and dimensional elements.


Developing a science of clinical utility in diagnostic classification systems field study strategies for ICD-11 mental and behavioral disorders.
The rationale and methodologies for an integrated and complementary set of field study strategies, including large international surveys, formative field studies of the structure of clinicians' conceptualization of mental disorders, and ecological implementation field Studies of clinical utility in the global settings in which the guidelines will ultimately be implemented are presented.
Mental health professionals' natural taxonomies of mental disorders: implications for the clinical utility of the ICD-11 and the DSM-5.
The clinical utility of the ICD-11 may be improved by making its structure more compatible with the common conceptual organization of mental disorders observed across diverse global clinicians.
A global clinicians’ map of mental disorders to improve ICD-11: Analysing meta-structure to enhance clinical utility
Clinician judgements can be used to improve clinical utility of the ICD-11 without sacrificing validity based on a scientific approach to enhancing a logically organized classification meta-structure.
New dimensions in the quantitative classification of mental illness.
The findings suggest that many PDs can be placed in Axis I with related clinical disorders, and that unipolar depression may be better placed with anxiety disorders than with bipolar disorders.
The cycle of classification: DSM-I through DSM-5.
The structural changes in the six editions of the Diagnostic and Statistical Manual of Mental Disorders and the research that influenced those changes are discussed.
Diagnosis and classification of disorders specifically associated with stress: proposals for ICD‐11
  • A. Maercker, C. Brewin, G. Reed
  • Psychology, Medicine
    World psychiatry : official journal of the World Psychiatric Association
  • 2013
Proposals include a narrower concept for PTSD that does not allow the diagnosis to be made based entirely on non‐specific symptoms, a new complex PTSD category that comprises three clusters of intra‐ and interpersonal symptoms in addition to core PTSD symptoms, and a new diagnosis of prolonged grief disorder.
The diagnosis of mental disorders: the problem of reification.
  • S. Hyman
  • Psychology, Medicine
    Annual review of clinical psychology
  • 2010
Based on accreting problems with the current DSM-fourth edition (DSM-IV) classification, it is apparent that validity will not be achieved simply by refining criteria for existing disorders or by the addition of new disorders.
Toward DSM-V and the classification of psychopathology.
The authors discuss issues that cut across individual diagnostic categories and that should receive particular attention in DSM-V: (a) the process by which the diagnostic manual is developed, (b) the differentiation from normal psychological functioning, (c) the differentiated among diagnostic categories, (d) cross-sectional vs. longitudinal diagnoses, and (e) the role of laboratory instruments.