UT Health Science Center helps revise the ‘bible of psychiatry’

SAN ANTONIO (Oct. 15, 2010) — A book often described as the bible of modern psychiatry is getting its first overhaul in nearly two decades, and The University of Texas Health Science Center at San Antonio is part of the process.

The UT Health Science Center will test the standards by which four mental disorders – depression, schizophrenia, bipolar disorder and attenuated psychotic syndrome – are diagnosed. Results will be incorporated into the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), a book that has guided mental health professionals since 1952.

The current edition of the DSM was published in 1994. The new revision is scheduled for release in May 2013.

The American Psychiatric Association described the selection process as very competitive; only 11 organizations were chosen from 65 that submitted proposals. The Health Science Center is one of just two test sites for bipolar disorder, schizophrenia and the newly proposed condition of attenuated psychotic syndrome, and it’s the only site conducting trials in three major psychiatric conditions in adults. The university will receive more than $200,000 for its participation.

“We are honored to be selected as one of the field trial sites,” said grant recipient Mauricio Tohen, M.D., Dr.P.H., M.B.A., the Krus Endowed Chair in Psychiatry at the Health Science Center. “Our role in the development of DSM-5 is a reflection of the Health Science Center’s standing in medical research, particularly in the field of psychiatry and mental disorders.”

The DSM provides descriptions, symptoms and other criteria for diagnosing mental disorders. Investigators participating in the field trials will evaluate new and existing patients at different stages of treatment using proposed DSM-5 diagnostic criteria. Among other things, they will test new tools to evaluate severity of symptoms and whether patients improve over time.

“An accurate diagnosis is a cornerstone of psychiatric research,” Dr. Tohen said. “The lack of validity and reliability in psychiatric diagnosis hampers any type of psychiatric research, including comparisons across studies and collaborations across sites. Most urgently, without accurate diagnosis we are not able to adequately treat our patients.”

The field trials follow a public comment period in which more than 8,000 written comments on the draft diagnostic criteria were submitted to the DSM-5 Web site by clinicians, researchers and family and patient advocates. Submitted comments were reviewed by DSM-5 work groups and resulted in adjustment of the criteria. The field trial results will help further refine the criteria.

More information on all of the participating field trial sites and the specific disorders being tested is available on www.dsm5.org.

Dr. Tohen is professor and head of the Division of Mood and Anxiety Disorders in the Department of Psychiatry of the UT Health Science Center’s School of Medicine. A native of Mexico, he joined the institution in February 2009 from Eli Lilly and Co. and previously was at Harvard Medical School/McLean Hospital, where he was the clinical director of the bipolar and psychotic disorders program. Bipolar disorder is his special interest. His research is funded by the National Institute of Mental Health, private foundations and the pharmaceutical industry. He is the current president of the International Society for Bipolar Disorders.

The University of Texas Health Science Center at San Antonio, one of the country’s leading health sciences universities, ranks in the top 3 percent of all institutions worldwide receiving National Institutes of Health (NIH) funding. Research and other sponsored program activity totaled a record $259 million in fiscal year 2009. The university’s schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have produced approximately 26,000 graduates. The $739 million operating budget supports eight campuses in San Antonio, Laredo, Harlingen and Edinburg. For more information on the many ways “We make lives better®,” visit www.uthscsa.edu.

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