Farías Venegas Camila, Varela Espinoza Luis Felipe, Ramírez Matta Christopher, Barra Cañas Bernardo, Araneda Maldonado Mónica, Sánchez Oñate Alejandro
Psychiatry, Universidad Andrés Bello, Santiago, CHL.
Psychiatry, Universidad de Los Andes, Chile, Santiago, CHL.
Cureus. 2025 May 21;17(5):e84580. doi: 10.7759/cureus.84580. eCollection 2025 May.
Psychiatric nosology, traditionally represented by the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM), is based on categorical diagnoses that have not met the current needs of clinicians. The so-called transdiagnostic approach appears to offer promise for classifying mental disorders. In the present study, our objective was to conduct a descriptive analysis of this approach in psychiatry based on the current literature. This study is a narrative review that utilized a bibliographic search for original and review articles on the transdiagnostic approach in psychiatry. The following keywords were used: "transdiagnostic", "psychiatry", "diagnosis", "approach", and "classification." Searches were conducted in PubMed, ScienceDirect, Scielo, the Cochrane Library, PsycINFO, Lilacs, and Hinari. Articles in English and Spanish with publication dates between 2003 and 2024 were included. A total of 261 records were identified for screening, and 104 were retrieved for full review. The DSM and ICD are systems that define aspects of our conceptualization of mental health. More recently, however, transdiagnostic perspectives have gained prominence, particularly through frameworks such as the RDoC (Research Domain Criteria) and HiTOP (Hierarchical Taxonomy of Psychopathology). The RDoC stands out for guiding research on the neurobiological bases of psychopathology. HiTOP is based on data and a hierarchy that conceptualizes psychopathology as a set of transdiagnostic dimensions and spectra. Both approaches, with their strengths and weaknesses, could be an interface and the basis for a new nosology in psychiatry. There is consensus on the need for a new operational framework for classification. The transdiagnostic approach could be the contemporary answer to this premise. The challenge is to develop further research and standardize the definition of the construct.
传统上由《国际疾病分类》（ICD）和《精神疾病诊断与统计手册》（DSM）所代表的精神科疾病分类法，基于尚未满足临床医生当前需求的类别诊断。所谓的跨诊断方法似乎为精神障碍的分类带来了希望。在本研究中，我们的目标是基于当前文献对精神科的这种方法进行描述性分析。本研究是一项叙述性综述，利用文献检索来查找有关精神科跨诊断方法的原创文章和综述文章。使用了以下关键词：“跨诊断”、“精神科”、“诊断”、“方法”和“分类”。检索在PubMed、ScienceDirect、Scielo、Cochrane图书馆、PsycINFO、Lilacs和Hinari中进行。纳入了2003年至2024年发表的英文和西班牙文文章。共识别出261条记录进行筛选，104条被检索出来进行全文审查。DSM和ICD是定义我们心理健康概念化方面的系统。然而，最近跨诊断观点变得突出，特别是通过诸如研究领域标准（RDoC）和精神病理学层次分类法（HiTOP）等框架。RDoC在指导精神病理学神经生物学基础的研究方面脱颖而出。HiTOP基于数据和一个层次结构，将精神病理学概念化为一组跨诊断维度和谱系。这两种方法各有优缺点，都可能成为精神科新分类法的一个接口和基础。对于需要一个新的分类操作框架已达成共识。跨诊断方法可能是对这一前提的当代回应。挑战在于开展进一步研究并规范该结构的定义。
