A new study points to the need for a more individualized approach to mental illness diagnoses to better meet patients’ needs and tailor their treatments.
Obsessive-compulsive disorder, addictions, dementia, schizophrenia, binge eating disorder, bipolar disorder… If it is possible today to define these mental illnesses in diagnostic terms, it is because they have all been “labelled” in categorical terms. by scientists who have listed the criteria: if the patients meet such criteria, it is then possible to make a diagnosis. While these pre-defined criteria are extremely important for making clinical decisions whether or not to treat patients, more and more specialist voices are speaking out against the rigid framework they erect. According to them, they do not reflect the true nature of mental illness.
Should we therefore revise these existing categorical frameworks? Numerous studies have already affirmed the need for it. According to their authors, there may be a significant overlap of mental disorders: most patients meet the criteria for multiple disorders. In addition, many mental disorders have commonalities, such as compulsiveness.
This is also the issue raised by a new study conducted by Trinity College Dublin. Published in JAMA Psychiatry, it raises the need for more individualized approaches to defining mental illness.
Respect the biology of the brain
To reach this conclusion, the researchers asked patients with obsessive-compulsive disorder (OCD) to answer a questionnaire on the clinical symptoms of their mental illness. On average, the latter responded to 3.7 concurrent diagnoses: although they receive the same diagnosis, patients may experience few or no overlapping symptoms and respond in entirely different ways to the same treatment.
These results therefore suggest, for the study authors, that self-reported levels of compulsive behavior are a better predictor of impairments in cognitive flexibility than a diagnosis of OCD in a person. “By defining mental health and mental illness in a way that is true to the biology of the brain and respects a reality that most mental illnesses vary within the population, we hope we are paving the way towards a future where treatments can be prescribed on a more individualized basis, based on well-defined brain systems and circuits and, above all, with a higher success rate,” explains lead author Dr Claire Gillan.
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