Sunday, November 04, 2007

LA TIMES - DSM Psych - "We don't know what we're doing"


Fine-tuning diagnostic labels for kids

November 5, 2007

A project that could help rewrite psychiatrists' diagnostic guidebook is underway at UCLA. The work, launched this summer by the National Institutes of Health, aims to put the diagnosis of several major psychiatric conditions -- including attention deficit hyperactivity disorder, bipolar disorder and schizophrenia -- on a more rigorous footing by identifying and mapping the biological processes that may link these diseases or distinguish them from one another.

Under the $22.5-million project, UCLA neuroscientists expect to explore how weakness in two cognitive skills -- working memory (sometimes called short-term memory) and impulse control -- may better identify people who have, or are developing, psychiatric disease. If clinicians can test patients for such measurable deficits, they might one day abandon the imprecise diagnostic labels and the trial-and-error medication decisions that characterize psychiatry today, says UCLA neuroscientist Robert Bilder, who leads the project.

Until then, it's hard to know whether mental-health professionals are overdiagnosing or underdiagnosing psychiatric disorders in kids or adults, Bilder says. Instead, he says, "there's an implicit misdiagnosis, since we don't know what we're doing."

-- Melissa Healy

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