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Open Access Highly Accessed Debate

Toward the future of psychiatric diagnosis: the seven pillars of RDoC

Bruce N Cuthbert13* and Thomas R Insel23

Author affiliations

1 National Institute of Mental Health, National Institutes of Health, 6001 Executive Boulevard, MSC 9632, Room 7121, Bethesda, MD 20892-9632, USA

2 National Institute of Mental Health, National Institutes of Health, 6001 Executive Boulevard, Room 8129, Bethesda, MD 20892, USA

3 Express/parcel delivery, Rockville, MD 20852, USA

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Citation and License

BMC Medicine 2013, 11:126  doi:10.1186/1741-7015-11-126

Published: 14 May 2013

Abstract

Background

Current diagnostic systems for mental disorders rely upon presenting signs and symptoms, with the result that current definitions do not adequately reflect relevant neurobiological and behavioral systems - impeding not only research on etiology and pathophysiology but also the development of new treatments.

Discussion

The National Institute of Mental Health began the Research Domain Criteria (RDoC) project in 2009 to develop a research classification system for mental disorders based upon dimensions of neurobiology and observable behavior. RDoC supports research to explicate fundamental biobehavioral dimensions that cut across current heterogeneous disorder categories. We summarize the rationale, status and long-term goals of RDoC, outline challenges in developing a research classification system (such as construct validity and a suitable process for updating the framework) and discuss seven distinct differences in conception and emphasis from current psychiatric nosologies.

Summary

Future diagnostic systems cannot reflect ongoing advances in genetics, neuroscience and cognitive science until a literature organized around these disciplines is available to inform the revision efforts. The goal of the RDoC project is to provide a framework for research to transform the approach to the nosology of mental disorders.

Keywords:
Diagnosis, DSM; ICD; Psychiatric diagnosis; Psychopathology; RDoC; Research domain criteria