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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. Research article

    The effectiveness of Stepping Stones Triple P parenting support in parents of children with borderline to mild intellectual disability and psychosocial problems: a randomized controlled trial

    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...

    Marijke Kleefman, Daniëlle EMC Jansen, Roy E Stewart and Sijmen A Reijneveld

    BMC Medicine 2014 12:191

    Published on: 28 October 2014

  2. Research article

    Concordance between DSM-IV and DSM-5 criteria for delirium diagnosis in a pooled database of 768 prospectively evaluated patients using the delirium rating scale-revised-98

    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...

    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…

    BMC Medicine 2014 12:164

    Published on: 30 September 2014

  3. Research article

    There are no randomized controlled trials that support the United States Preventive Services Task Force guideline on screening for depression in primary care: a systematic review

    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...

    Brett D Thombs, Roy C Ziegelstein, Michelle Roseman, Lorie A Kloda and John PA Ioannidis

    BMC Medicine 2014 12:13

    Published on: 28 January 2014

  4. Forum

    DSM-5: a collection of psychiatrist views on the changes, controversies, and future directions

    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...

    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

    BMC Medicine 2013 11:202

    Published on: 12 September 2013

  5. Opinion

    So depression is an inflammatory disease, but where does the inflammation come from?

    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...

    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

    BMC Medicine 2013 11:200

    Published on: 12 September 2013

  6. Question and Answer

    The DSM-5 - an interview with David Kupfer

    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...

    David Kupfer

    BMC Medicine 2013 11:203

    Published on: 12 September 2013

  7. Question and Answer

    DSM-5 and ADHD – an interview with Eric Taylor

    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.

    Eric Taylor

    BMC Medicine 2013 11:204

    Published on: 12 September 2013

  8. Commentary

    Patient advocacy and DSM-5

    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...

    Dan J Stein and Katharine A Phillips

    BMC Medicine 2013 11:133

    Published on: 17 May 2013

  9. Review

    Personalized medicine in psychiatry: problems and promises

    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...

    Uzoezi Ozomaro, Claes Wahlestedt and Charles B Nemeroff

    BMC Medicine 2013 11:132

    Published on: 16 May 2013

  10. Debate

    Clinical classification in mental health at the cross-roads: which direction next?

    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...

    Ian B Hickie, Jan Scott, Daniel F Hermens, Elizabeth M Scott, Sharon L Naismith, Adam J Guastella, Nick Glozier and Patrick D McGorry

    BMC Medicine 2013 11:125

    Published on: 14 May 2013

  11. Editorial

    The DSM-5: Hyperbole, Hope or Hypothesis?

    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...

    Michael Berk

    BMC Medicine 2013 11:128

    Published on: 14 May 2013

  12. Opinion

    Diet, a new target to prevent depression?

    Research on the role of diet in the prevention of depression is scarce. Some evidence suggests that depression shares common mechanisms with cardiovascular disease.

    Almudena Sanchez-Villegas and Miguel A Martínez-González

    BMC Medicine 2013 11:3

    Published on: 3 January 2013