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Current Controversies in Psychiatry

Psychiatry is an important medical speciality, and several topics on the diagnosis, treatment and prevention of mental disorders are currently being debated. The area of diagnosis has attracted much dialogue with the recent launch of the DSM-5; the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. Development of a new psychiatric classification system, Research Domain Criteria (RDoC), by the National Institute of Mental Health in 2009, is a decade-long research framework, that aims to incorporate genetics, neuroimaging and cognitive science with a move towards precision medicine for mental disorders. Mental disorders are associated with physical health problems and there are many initiatives to make mental health a key public health priority. For example, depression is known to increase the risk of cardiovascular disease, stroke, diabetes and obesity morbidity. Emerging evidence is showing that risk factors for common mental disorders like anxiety include lifestyle behaviors such as diet, physical inactivity and smoking. Understanding the relationship between physical and mental health will help drive prevention strategies in mental health by building on established schemes and developing approaches used for noncommunicable somatic diseases. This article collection on the current controversies in psychiatry seeks to address the key challenges in mental health from diagnosis to co-morbidities. The series also focuses on precision medicine where advances in genetics, epigenetics, biomarkers, treatment response and environmental factors will facilitate understanding of vulnerability and the requirement of specific therapies for mental disorders. Further submissions of original research, reviews and debates focusing on the controversies and open questions in psychiatry are encouraged.

  1. Children with borderline to mild intellectual disability (BMID) have been shown to be at increased risk for psychosocial problems. The presence of these psychosocial problems leads to parenting stress. Steppin...

    Authors: Marijke Kleefman, Daniëlle EMC Jansen, Roy E Stewart and Sijmen A Reijneveld
    Citation: BMC Medicine 2014 12:191
  2. The Diagnostic and Statistical Manual fifth edition (DSM-5) provides new criteria for delirium diagnosis. We examined delirium diagnosis using these new criteria compared with the Diagnostic and Statistical Manua...

    Authors: David J Meagher, Alessandro Morandi, Sharon K Inouye, Wes Ely, Dimitrios Adamis, Alasdair J Maclullich, James L Rudolph, Karin Neufeld, Maeve Leonard, Giuseppe Bellelli, Daniel Davis, Andrew Teodorczuk, Stefan Kreisel, Christine Thomas, Wolfgang Hasemann, Suzanne Timmons…
    Citation: BMC Medicine 2014 12:164
  3. The United States Preventive Services Task Force (USPSTF) recommends screening adults for depression in primary care settings when staff-assisted depression management programs are available. This recommendati...

    Authors: Brett D Thombs, Roy C Ziegelstein, Michelle Roseman, Lorie A Kloda and John PA Ioannidis
    Citation: BMC Medicine 2014 12:13
  4. In this podcast we talk to Prof Eric Taylor about the changes to the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) in DSM-5 and how these changes will affect clinical practice.

    Authors: Eric Taylor
    Citation: BMC Medicine 2013 11:204
  5. In this podcast we talk to Prof David Kupfer about the challenges, controversies and future directions of DSM-5 by considering other research frameworks and classification systems of disease, and how this revi...

    Authors: David Kupfer
    Citation: BMC Medicine 2013 11:203
  6. The recent release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association has led to much debate. For this forum article, we asked BMC Me...

    Authors: Charles B Nemeroff, Daniel Weinberger, Michael Rutter, Harriet L MacMillan, Richard A Bryant, Simon Wessely, Dan J Stein, Carmine M Pariante, Florian Seemüller, Michael Berk, Gin S Malhi, Martin Preisig, Martin Brüne and Paul Lysaker
    Citation: BMC Medicine 2013 11:202
  7. We now know that depression is associated with a chronic, low-grade inflammatory response and activation of cell-mediated immunity, as well as activation of the compensatory anti-inflammatory reflex system. It...

    Authors: Michael Berk, Lana J Williams, Felice N Jacka, Adrienne O’Neil, Julie A Pasco, Steven Moylan, Nicholas B Allen, Amanda L Stuart, Amie C Hayley, Michelle L Byrne and Michael Maes
    Citation: BMC Medicine 2013 11:200
  8. The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) provides a useful opportunity to revisit debates about the nature of psychiatric classification. An important debate concerns the...

    Authors: Dan J Stein and Katharine A Phillips
    Citation: BMC Medicine 2013 11:133
  9. The central theme of personalized medicine is the premise that an individual’s unique physiologic characteristics play a significant role in both disease vulnerability and in response to specific therapies. Th...

    Authors: Uzoezi Ozomaro, Claes Wahlestedt and Charles B Nemeroff
    Citation: BMC Medicine 2013 11:132
  10. Depression is the most common psychiatric disorder worldwide. The burden of disease for depression goes beyond functioning and quality of life and extends to somatic health. Depression has been shown to subseq...

    Authors: Brenda WJH Penninx, Yuri Milaneschi, Femke Lamers and Nicole Vogelzangs
    Citation: BMC Medicine 2013 11:129
  11. The furore preceding the release of the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is in contrast to the incremental changes to several diagnostic categories, which are de...

    Authors: Michael Berk
    Citation: BMC Medicine 2013 11:128
  12. After 30 years of consensus-derived diagnostic categories in mental health, it is time to head in new directions. Those categories placed great emphasis on enhanced reliability and the capacity to identify the...

    Authors: Ian B Hickie, Jan Scott, Daniel F Hermens, Elizabeth M Scott, Sharon L Naismith, Adam J Guastella, Nick Glozier and Patrick D McGorry
    Citation: BMC Medicine 2013 11:125
  13. Research on the role of diet in the prevention of depression is scarce. Some evidence suggests that depression shares common mechanisms with cardiovascular disease.

    Authors: Almudena Sanchez-Villegas and Miguel A Martínez-González
    Citation: BMC Medicine 2013 11:3