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Zwölf Jahre Research Domain Criteria in der psychiatrischen Forschung und Praxis: Anspruch und Wirklichkeit

Twelve years of research domain criteria in psychiatric research and practice: claim and reality

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Zusammenfassung

Vor 12 Jahren wurde die Research-Domain-Criteria(RDoC)-Initiative des National Institute of Mental Health (NIMH) vorgestellt. Die RDoC bietet eine Matrix für die systematische, dimensionale und domänenbasierte Erforschung psychischer Störungen, die nicht auf vorher definierten Krankheitsentitäten im Sinne des Diagnostic and Statistical Manual of Mental Disorders (DSM) oder der International Classification of Diseases (ICD) basiert. Das primäre Ziel von RDoC ist es, die Natur psychischer Gesundheit und Krankheit im Hinblick auf unterschiedliche Ausprägungen der Dysfunktion in diagnoseübergreifenden psychologischen/biologischen Systemen zu verstehen. Diese selektive Übersichtsarbeit soll einen umfassenden Überblick über RDoC-basierte Studien geben, die zur besseren konzeptionellen Organisation psychischer Erkrankungen beigetragen haben. Es wurden zahlreiche und methodisch anspruchsvolle Studien zum Thema RDoC identifiziert. Die Anzahl der wissenschaftlichen Studien nahm im Laufe der Zeit zu, was auf eine zunehmende auf Dimensionen basierende Forschung in der Psychiatrie hindeutet. Zusammenfassend lässt sich sagen, dass die RDoC-Initiative ein erhebliches Potenzial hat, die Pathomechanismen psychischer Erkrankungen in ihrer Komplexität genauer zu definieren. In der Zukunft müssen aber noch große Herausforderungen (z. B. kleine und heterogene Stichproben, unklare Biomarkerdefinitionen und fehlende Replikation) bewältigt werden. Darüber hinaus ist plausibel, dass eine Diagnostik der Zukunft dimensionale und kategoriale Ansätze integrieren wird, um zu einer therapeutisch relevanten Stratifizierung zu kommen.

Abstract

The research domain criteria (RDoC) initiative of the National Institute of Mental Health (NIMH) was presented 12 years ago. The RDoC provides a matrix for the systematic, dimensional and domain-based study of mental disorders that is not based on established disease entities as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD). The primary aim of RDoC is to understand the nature of mental health and illness in terms of different extents of dysfunction in psychological/biological systems with interconnected diagnoses. This selective review article aims to provide a comprehensive overview of RDoC-based studies that have contributed to a better conceptual organization of mental disorders. Numerous promising and methodologically sophisticated studies on RDoC were identified. The number of scientific studies increased over time, indicating that dimensional research is increasingly being pursued in psychiatry. In summary, the RDoC initiative has a considerable potential to more precisely define the complexity of pathomechanisms underlying mental disorders; however, major challenges (e.g. small and heterogeneous study samples, unclear biomarker definitions and lack of replication studies) remain to be overcome in the future. Furthermore, it is plausible that a diagnostic system of the future will integrate categorical and dimensional approaches to arrive at a stratification that can underpin a precision medical approach in psychiatry.

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Authors and Affiliations

  1. Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät Mannheim, Universität Heidelberg, 68159, Mannheim, Deutschland

    Dusan Hirjak, Emanuel Schwarz & Andreas Meyer-Lindenberg

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  1. Dusan Hirjak
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  2. Emanuel Schwarz
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  3. Andreas Meyer-Lindenberg
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Correspondence to Dusan Hirjak.

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D. Hirjak, E. Schwarz und A. Meyer-Lindenberg geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Hirjak, D., Schwarz, E. & Meyer-Lindenberg, A. Zwölf Jahre Research Domain Criteria in der psychiatrischen Forschung und Praxis: Anspruch und Wirklichkeit. Nervenarzt 92, 857–867 (2021). https://doi.org/10.1007/s00115-021-01174-1

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