New psychology study finds people typically experience shifting mental disorders – Health News Today
New research based on four decades of longitudinal data indicates that it is rare for a person to receive and keep a single mental disorder diagnosis. Rather, experiencing different successive mental disorders appears to be the norm.
The findings, published in JAMA Open, suggest that psychiatrists and other mental health professionals should move toward adopting a life-course perspective on mental disorders.
“The practice of diagnosing mental disorders is at a crossroads. The Diagnostic and Statistical Manual of Mental Disorders (DSM), which provides guidelines for diagnostic practice, is being questioned, not just by the ‘anti-psychiatry’ movement, but by detractors within the discipline itself,” explained study author Avshalom Caspi, a professor of psychology and neuroscience at Duke University.
“The U.S. National Institute of Mental Health, a major funder of mental health research internationally, has called for a new approach to studying mental illness, to be shaped by investigating research domains rather than by investigating traditional categorical diagnoses. And the public is confused about what constitutes a mental disorder, a confusion resulting in ‘diagnosis shopping.’”
“Our thesis is that progress in conceptualizing mental disorders has been delayed by the field’s limiting focus on cross-sectional information. Mental-health professionals typically encounter a patient at one point in his or her life. This cross-sectional view fosters a focus on the current presenting disorder, on the assumption that diagnosis informs about etiology and prognosis. But we actually know very little about how mental disorders unfold over the life span,” Caspi said.
The researchers examined data from the Dunedin Longitudinal Study in New Zealand, which used repeated standardized psychiatric assessments to track 17 mental health conditions from age 11 to age 45. The study included more than one thousand participants and the mental health conditions were diagnosed according to DSM criteria.
“These disorders included externalizing disorders (for example, ADHD, conduct disorder, substance dependence), internalizing disorders (for example, depression, anxiety, eating disorders, PTSD), and thought disorders (for example, mania, schizophrenia, OCD). This is the most detailed time series of mental-disorder life-histories ever assembled,” Caspi explained.
The study also included neurocognitive examinations during childhood and adolescence, along with a neuroimaging-based assessment of brain aging at age 45.
About one-third of the participants experienced the initial onset of a disorder by age 15 years and 86% met the criteria for at least one disorder by age 45 years.
The researchers found an “ebb and flow” of mental disorders over time. Participants with a disorder from any one of the three diagnostic families were at higher risk for disorders from other diagnostic families in the future. Participants characterized by one consistent mental…