RDoC research initiative aims to help guide classification of patients in clinical studies

A new effort by the National Institutes of Health will facilitate communication among scientists, clinicians, and the public to reframe mental health research, from diagnosis to treatment. The Research Domain Criteria (RDoC) unit was recently established by the National Institute of Mental Health (NIMH), part of NIH, to support the development of the institute's RDoC initiative.

The aim of the RDoC initiative is to accelerate the pace of research that translates basic science into clinical settings by understanding the multi-layered systems that contribute to mental function. The RDoC approach emphasizes neurodevelopment and environmental effects, in keeping with modern views about the genesis of mental disorders.

"The RDoC unit is the culmination of over five years of effort from the institute and members of the research community," said RDoC unit Director Bruce N. Cuthbert, Ph.D., who has served as coordinator of the RDoC working group since its inception. "We will now have four full-time staff to coordinate the program and enhance communication with scientists and the public as RDoC grows."

"RDoC represents a significant paradigm shift in the way we think about and study mental disorders," said Thomas R. Insel, M.D., director of NIMH. "The RDoC approach cuts across traditional diagnostic categories to identify relationships among observable behavior, neurobiological measures, and patient self-report of mental status."

Open communication has been one of the defining features of the RDoC initiative since it began in 2009. Cuthbert and the RDoC working group hosted a series of workshops that brought NIMH staff together with researchers and clinicians from a wide range of specialties. Together they laid the groundwork for RDoC by defining and organizing an initial set of fundamental units of mental functioning (called domains) into the RDoC research matrix.

The RDoC unit will continue to adopt transparent communication as a means to improve upon the RDoC framework. The unit is developing a new online discussion forum, expected to launch in the next few months, where investigators and clinicians can continue to converse and collaborate with each other around the RDoC framework in a virtual environment.

"The basic framework of RDoC was built as a dynamic template that will continually grow and evolve as research progresses," Cuthbert noted. "Through the RDoC discussion forum, we are inviting the research community to help us refine the RDoC matrix by weighing in on the current framework and suggesting new domains, constructs, and units of analysis."

Data sharing is also central to the RDoC initiative. The RDoC Database will use the same data-sharing platform that NIMH created for the National Database for Autism Research (NDAR), which now hosts de-identified data from over 77,000 human subjects. As the number of data sets in the database increases, researchers will be able to better use data mining practices to identify subgroups of patients within current diagnostic categories and ultimately develop better-tailored treatments.

The RDoC unit is essential for the expansion of the RDoC initiative. Unit staff will provide information to current and potential grantees, respond to inquiries, organize scientific events, support education and training, and conduct liaison with other agencies in the United States and around the world. They will also coordinate the growth of the RDoC grant portfolio, which is expected to take up an increasing portion of NIMH-funded clinical research in the years to come.

"This is an exciting time for NIMH," remarked Insel. "With the establishment of the RDoC unit, we are one step closer to bringing precision medicine to the diagnosis and treatment of mental disorders."