New research based on four decades of longitudinal data indicates that it is rare for a person to receive and keep a single mental disorder diagnosis. Rather, experiencing different successive mental disorders appears to be the norm.
The findings, published in JAMA Open, suggest that psychiatrists and other mental health professionals should move toward adopting a life-course perspective on mental disorders.
“The practice of diagnosing mental disorders is at a crossroads. The Diagnostic and Statistical Manual of Mental Disorders (DSM), which provides guidelines for diagnostic practice, is being questioned, not just by the ‘anti-psychiatry’ movement, but by detractors within the discipline itself,” explained study author Avshalom Caspi, a professor of psychology and neuroscience at Duke University.
“The U.S. National Institute of Mental Health, a major funder of mental health research internationally, has called for a new approach to studying mental illness, to be shaped by investigating research domains rather than by investigating traditional categorical diagnoses. And the public is confused about what constitutes a mental disorder, a confusion resulting in ‘diagnosis shopping.’”
“Our thesis is that progress in conceptualizing mental disorders has been delayed by the field’s limiting focus on cross-sectional information. Mental-health professionals typically encounter a patient at one point in his or her life. This cross-sectional view fosters a focus on the current presenting disorder, on the assumption that diagnosis informs about etiology and prognosis. But we actually know very little about how mental disorders unfold over the life span,” Caspi said.
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