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False dogmas in mood disorders research: Towards a nomothetic network approach
journal contributionposted on 2023-02-20, 04:25 authored by Michael HJ Maes, Drozdstoy Stoyanov
The current understanding of major depressive disorder (MDD) and bipolar disorder (BD) is plagued by a cacophony of controversies as evidenced by competing schools to understand MDD/BD. The DSM/ICD taxonomies have cemented their status as the gold standard for diagnosing MDD/BD. The aim of this review is to discuss the false dogmas that reign in current MDD/BD research with respect to the new, data-driven, machine learning method to model psychiatric illness, namely nomothetic network psychiatry (NNP). This review discusses many false dogmas including: MDD/BD are mind-brain disorders that are best conceptualized using a bio-psycho-social model or mind-brain interactions; mood disorders due to medical disease are attributable to psychosocial stress or chemical imbalances; DSM/ICD are the gold standards to make the MDD/BD diagnosis; severity of illness should be measured using rating scales; clinical remission should be defined using threshold values on rating scale scores; existing diagnostic BD boundaries are too restrictive; and mood disorder spectra are the rule. In contrast, our NNP models show that MDD/BD are not mind-brain or psycho-social but systemic medical disorders; the DSM/ICD taxonomies are counterproductive; a shared core, namely the reoccurrence of illness (ROI), underpins the intertwined recurrence of depressive and manic episodes and suicidal behaviors; mood disorders should be ROI-defined; ROI mediates the effects of nitro-oxidative stress pathways and early lifetime trauma on the phenome of mood disorders; severity of illness and treatment response should be delineated using the NNP-derived causome, pathway, ROI and integrated phenome scores; and MDD and BD are the same illness.
JournalWORLD JOURNAL OF PSYCHIATRY
PublisherBAISHIDENG PUBLISHING GROUP INC
CategoriesNo categories selected
Science & TechnologyLife Sciences & BiomedicinePsychiatryNomothetic network psychiatryDepressionMood disordersAffective disordersInflammationOxidative and nitrosative stressNeuro-immuneMAJOR DEPRESSIONBIPOLAR DISORDERIMMUNE ACTIVATIONPATHWAY-PHENOTYPEOXIDATIVE STRESSDIAGNOSISSPECTRUMSYMPTOMSCRITERIAILLNESSBehavioral and Social ScienceBrain DisordersClinical ResearchMental HealthSerious Mental IllnessMental health3 Good Health and Well Being