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[研究领域标准(RDoC):作为应用认知神经科学的精神病学研究]

[Research domain criteria (RDoC) : Psychiatric research as applied cognitive neuroscience].

作者信息

Walter H

机构信息

Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.

出版信息

Nervenarzt. 2017 May;88(5):538-548. doi: 10.1007/s00115-017-0284-4.

Abstract

BACKGROUND

Just before the official launch of the DSM-5 in 2013, the Research Domain Criteria (RDoC) initiative of the National Institute of Mental Health was made public and is becoming increasingly more important in psychiatric research.

OBJECTIVE

The aim of this paper is to clarify the conceptual approach of RDoC, to systematically discuss limitations, to present exemplary RDoC-based studies and to consider the relevance of the RDoC concepts for clinicians and scientists.

MATERIAL AND METHODS

The is a qualitative introduction and review article with a critical discussion.

RESULTS AND DISCUSSION

The RDoC initiative was not conceived as an alternative diagnostic manual to DSM-5 or IDC-10/11 for use in clinical practice. It is a new systematic framework for psychiatric research based on the most recent results of cognitive neuroscience and aims to map mental disorders dimensionally and transdiagnostically. Despite some weaknesses, it is currently the most elaborated and scientifically grounded approach for multidisciplinary research on mental disorders. In contrast to the purely symptom-based DSM and ICD approaches, which are agnostic with respect to the pathogenesis of mental diseases, the explicit aim of the RDoC initiative is to systematize biological knowledge about risk factors and causes of mental disorders; therefore, it has a much greater potential to develop new and individualized therapeutic strategies based on disease mechanisms.

摘要

背景

2013年《精神疾病诊断与统计手册》第5版(DSM-5)正式发布前夕,美国国立精神卫生研究所的研究领域标准(RDoC)计划公布,并在精神病学研究中变得越来越重要。

目的

本文旨在阐明RDoC的概念方法,系统讨论其局限性,展示基于RDoC的范例研究,并探讨RDoC概念对临床医生和科学家的相关性。

材料与方法

这是一篇进行批判性讨论的定性介绍和综述文章。

结果与讨论

RDoC计划并非作为DSM-5或国际疾病分类第10/11版(IDC-10/11)的替代诊断手册用于临床实践。它是一个基于认知神经科学最新成果的精神病学研究新系统框架,旨在从维度和跨诊断角度描绘精神障碍。尽管存在一些弱点,但它目前是精神障碍多学科研究中最详尽且有科学依据的方法。与纯粹基于症状的DSM和ICD方法不同,后者对精神疾病的发病机制不做判断,RDoC计划的明确目标是将关于精神障碍风险因素和病因的生物学知识系统化;因此,它在基于疾病机制开发新的个体化治疗策略方面具有更大潜力。

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