Why psychiatric research must abandon traditional diagnostic classification and adopt a fully dimensional scope: Two solutions to a persistent problem

Abstract

Psychiatric research is still strongly influenced by its major classification schemes, the DSM-5 (1) and ICD-10 (2). According to these diagnostic classification systems, psychiatric nosology is construed based on multinomial taxonomic distinctions, i.e., a set of putatively independent disorder entities that are either present or absent based on polythetic-categorical criteria. Many published papers in psychiatry use these dichotomous diagnoses as the main unit of analysis. However, as it stands, these classification systems have major limitations that substantially impede scientific progress (3-5). In the following, we will detail why DSM/ICD-based approaches to the study of mental disorders are inadequate ways to address psychopathology. We will outline the major limitations of categorical psychiatric diagnoses as implemented in the current classification systems, and then we will introduce two promising approaches that were designed to circumvent these caveats.