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Prof. Mario Maj

 

Mario Maj Controversias Psiquiatria Barcelona
Talk The crisis of confidence in the DSM paradigm and the future of psychiatric diagnosis
Date Friday, April 21st, 2017
Time 09:45 - 10:30

 
BIOGRAPHY

Mario Maj is Professor of Psychiatry and Chairman at the University of Naples SUN, Naples, Italy, and Director of the Italian WHO Collaborating Center for Research and Training in Mental Health.

He has been President of the World Psychiatric Association, the European Psychiatric Association and the Italian Psychiatric Association. He is Editor of World Psychiatry, official journal of the World Psychiatric Association (impact factor 2016: 20.205, no. 1 among psychiatric journals).

He is member of the Advisory Board for the Chapter on Mental and Behavioural Disorders of the ICD-11, and Chairperson of the Work Group on Mood and Anxiety Disorders for that chapter. He has been member of the Work Group for Mood Disorders of the DSM-5.

He is Honorary Fellow of the Royal College of Psychiatrists, UK, and of the American College of Psychiatrists, and Doctor Honoris Causa at the University of Craiova.

He has been active as a researcher and an educator on behalf of the WHO in sub-Saharan Africa, South East Asia and Latin America. He has been Chairman of the Section on Neuropsychiatry of the Global Programme on AIDS at the WHO Headquarters in Geneva.

He is member of the Editorial Board of several international journals. He has been author of more than 450 scientific papers indexed in Scopus, mostly in the area of mood, psychotic and eating disorders. His H-index (Google Scholar) is 68.

 
ABSTRACT

The publication of the DSM-III in 1980 was intended to be a reaction to the evidence of the embarrassingly low reliability of psychiatric diagnoses, which was perceived as a major threat to the credibility of the psychiatric profession. The aims of the DSM-III project were actually two. First, the reliable definition of the diagnostic categories was expected to lead to the collection of research data that would validate those diagnostic entities and in particular elucidate their etiopathogenetic underpinnings. Second, there was an expectation that, by increasing reliability, communication among clinicians would be improved and clinical decisions made more rational. Today, one could say that the first aim of the project has not been achieved, while the fulfilment of the second aim has never been tested appropriately. The crisis of confidence in the DSM paradigm, clearly emerging from the debate following the publication of the DSM-5, has led on the one hand to a renewed emphasis on clinical utility, which is featuring prominently in the ongoing process of development of the ICD-11 (1). On the other hand, it has led to a radical attempt to reform psychiatric nosology starting from neurobiological and behavioural phenotypes (2). This attempt does have its weaknesses, but may also represent a stimulus to reconceptualize some psychopathological constructs, especially in the area of psychoses, in order to reduce the gap between the level of neuroscience and that of clinical phenomenology.

 
REFERENCES

1. First MB, Reed GM, Hyman SE, Saxena S. The development of the ICD-11 Clinical Descriptions and Diagnostic Guidelines for Mental and Behavioural Disorders. World Psychiatry 2015;14:82-90.

2. Cuthbert BN. The RDoC framework: facilitating transition from ICD/DSM to dimensional approaches that integrate neuroscience and psychopathology. World Psychiatry 2014;13:28-35.