Mental Health Bookclub discussion

Article available here: https://www.nature.com/articles/d4158...

Here are some main points:

Few patients fit into each neat set of criteria. Instead, people often have a mix of symptoms from different disorders. Even if someone has a fairly clear diagnosis of depression, they often have symptoms of another disorder such as anxiety. “If you have one disorder, you’re much more likely to have another,” says Ted Satterthwaite, a neuropsychiatrist at the University of Pennsylvania in Philadelphia.

This implies that the way clinicians have partitioned mental disorders is wrong. Psychiatrists have tried to solve this by splitting disorders into ever-finer subtypes. “If you look at the way the DSM has evolved over time, the book gets thicker and thicker,” says Satterthwaite. But the problem persists — the subtypes are still a poor reflection of the clusters of symptoms that many patients have.

The way DSM-5 categorizes mental illness can be found here: https://en.wikipedia.org/wiki/DSM-5

One prominent model is that there are a number of neuropsychological traits or ‘dimensions’ that vary in every person. Each trait determines our susceptibility to certain kinds of disorder. For example, someone might be prone to mood disorders such as anxiety, but not to thought disorders such as schizophrenia.

This is similar to the way psychologists think about personality. In one model, five personality traits, such as conscientiousness and neuroticism, describe most of the variation in human personalities.
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In 2019, the World Health Assembly endorsed the latest International Classification of Diseases (called ICD-11), in which some psychopathologies were newly broken down using dimensional symptoms rather than categories.

If you are interested the ICD-11 is available here https://icd.who.int/browse11/l-m/en#/... . Click on the categories on the left to see details.

The challenge for the dimensionality hypothesis is obvious: how many dimensions are there, and what are they? Satterthwaite calls this “a very large problem”.

What do you guys think of this? I see many of us in this group have multiple diagnoses and they have overlapping symptoms. Kind of seems they might have a point.