Patients, doctors and pharma companies set out plans to improve mental health diagnosis

An international group of psychiatrists, patient associations, and pharmaceutical companies has unveiled plans to systematically include objective biological tests in the diagnosis of psychiatric conditions. This Precision Psychiatry Roadmap, which may radically change the practice of psychiatry, is published in the journal Molecular Psychiatry.

The project was coordinated by Martien Kas, professor of behavioral neuroscience at the Groningen Institute for Evolutionary Life Sciences (GELIFES), University of Groningen.

“Many current treatments don’t work well for all patients, so there is a real need for better mental health treatment, and that starts with more accurate diagnosis,” he says. The paper sets out a roadmap to incorporate biological measurements in the diagnosis over the next 15 to 20 years, aiming to bring the right treatment to the right patient at the right time.

Common biological causes

Currently, mental health problems are diagnosed via the patient’s responses to a series of questions, as defined in two major handbooks, the DSM (Diagnostic and Statistical Manual of Mental Disorders) and the ICD (International Classification of Diseases). Although these handbooks are the state-of-the-art at the moment, the responses can often be subjective or vague, leading to problems in diagnosis and treatment.

“Furthermore, we see common symptoms across different mental health conditions,” explains Kas. “Anxiety, for example, can be a symptom of various mental health conditions, each of which is treated differently.” Using a biological test could help reveal if these common symptoms are due to common biological causes.

A living document

The roadmap was initiated by the European College of Neuropsychopharmacology (ECNP), of which Professor Kas is the current chair. “However, it doesn’t just belong to the ECNP, there is general interest in this, and we have to do this together as a field.”

The plan sets out steps for the systematic development and use of tests such as MRI imaging, smartphone feedback, blood tests and so on. These will eventually be integrated with the tests in the currently-used diagnostic manuals.

In this way, the diagnostic handbook will become a living document that evolves as the science progresses.

Professor Kas said, “To achieve this, we must coordinate at a global level to ensure consistency of diagnosis and reach consensus on the predictive validity of the new biological correlates identified. We have already brought together representatives of the major psychiatric organizations, patient associations, and the pharmaceutical industry.”