Title: Mental health: On the spectrum : Nature News & Comment
Headings: Mental health: On the spectrum
Mental health: On the spectrum
Manual evolution
“We need to give researchers permission to think outside these traditional silos.”
Rival approach
Change of tack
References
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Content: Studies with functional magnetic resonance imaging show that people with anxiety disorders and those with mood disorders share a hyperactive response of the brain's amygdala region to negative emotion and aversion 1. Similarly, those with schizophrenia and those with post-traumatic stress disorder both show unusual activity in the prefrontal cortex when asked to carry out tasks that require sustained attention 1. And in the largest study yet undertaken to try to pinpoint the genetic roots of mental disorder, a group led by Jordan Smoller at the Massachusetts General Hospital in Boston screened genome information from more than 33,000 people with five major mental-health syndromes, looking for genetic sequences associated with their illness 2. At the end of February, the team reported that some genetic risk factors — specifically, four chromosomal sites — are associated with all five disorders: autism, attention deficit hyperactivity disorder, bipolar disorder, major depression and schizophrenia. “ What we see in the genetics mirrors what we see in the clinic,” Hyman says. “ We are going to have to have a rethink.” Rival approach
At the same time that research and clinical practice are helping to undermine the DSM categories, the rival dimensional approach is gaining support. Over the past decade, psychiatrists have proposed a number of such dimensions, but they are not used in practice — partly because they are not sanctioned by the DSM. The frequent co-morbidity between schizophrenia and OCD, for instance, has led some to suggest a schizo-obsessive spectrum, with patients placed according to whether they attribute intrusive thoughts to an external or internal source.