In an article published in the current issue of Psychotherapy and Psychosomatics, researchers from the University of Bologna and Bern analyze the state of biological research in mental disorders.
Current diagnostic definitions of psychiatric disorders based on collections of symptoms encompass very heterogeneous populations, and are thus likely to yield spurious results when exploring biological correlates of mental disturbances.
It has recently been introduced the idea that large studies of biomarkers across diagnostic entities may yield improvement in clinical information. Such a view is rooted in a concept of assessment as a collection of symptoms, devoid of any clinical judgment and interpretation. Yet, important advances have been made in recent years in clinimetrics, the science of clinical judgment.
The current clinical taxonomy in psychiatry, which emphasizes reliability often at the cost of clinical validity, does not include meaningful information on effects of comorbid conditions, timing of phenomena, rate of progression of an illness, responses to previous treatments, and other clinical distinctions that demarcate major prognostic and therapeutic differences among patients who otherwise seem to be deceptively similar since they share the same psychiatric diagnosis.
The lead Author of the study, Professor Giovanni Fava, observes: "The recent strategies of the National Institute of Mental Health launching biological research for mental disorders may be a road to nowhere and a huge waste of public money, unless more attention to clinical data is paid".
The adoption of a clinimetric approach may provide the missing link between clinical states and biomarkers in psychiatry, building pathophysiological bridges from clinical manifestations to their neurobiological counterparts.