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Towards a biopsychosocial nosology of mental illness: challenges and opportunities for psychiatric epidemiology
  1. Carlos G Forero1,2,
  2. José I Castro-Rodríguez3,4,
  3. Jordi Alonso1,2,4
  1. 1CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
  2. 2Health Services Research Group, IMIM—Hospital del Mar Medical Research Institute, Barcelona, Spain
  3. 3Institute of Neuropsychiatry and Addictions (INAD), Parc de Salut Mar, Barcelona, Spain
  4. 4Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
  1. Correspondence to Dr Carlos García Forero, Health Services Research Unit, CIBERESP/IMIM-Hospital del Mar Research Institute, Doctor Aiguader 88, Barcelona 08003, Spain; cgarcia{at}

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More than a year after the publication of the fifth Diagnostic and Statistical Manual of Psychiatric disorders (DSM) instalment,1 the debate regarding its significance is still quite active. Controversy about this version thrived long before this edition, as it was envisaged in the neuropsychiatric community as an advance from syndromic categorical classification to a nosology based on psychobiological research.2–4

This new DSM version generated—and still generates—much debate. Strong opinions were held on how DSM-5 should be an opportunity for figuring out the future of a biological psychiatry.4 With so many voices to be heard it is not surprising that the final version fell short from the high expectations. This sensation substantiated when the National Institute of Mental Health announced that it would re-orient away from the DSM and adhered fully to the Research Domain Criteria (RDoC) project2: a research initiative for promoting a new psychopathology based on dimensions of observable behaviour and neurobiological measures. The RDoC consists on a roadmap for translational research on mental health based on a grid of biological domain systems to be studied from different sources of evidence. The domain systems (cognitive, social processing, arousal, negative and positive valence systems) are assumed to function dimensionally, going from normal to abnormal functioning, from well-being to pathology. According to the RDoC, evidence about these systems is to be approached by different units of analysis (genetic, molecular, cellular, neurocircuitry, physiological, behavioural, self-reported and experimental).2

The controversy goes beyond categorical versus dimensional …

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  • Contributors CGF drafted the work and JIC and JA revised it critically for important intellectual content. All authors contributed to the editorial with substantial contributions to the conception or design of the work and all authors gave their final approval to the current version to be published.

  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.