By: Stephanie Pappas, LiveScience Senior Writer
Published: 05/03/2013 03:43 PM EDT on LiveScience
The National Institute of Mental Health is moving away from the Diagnostic and Statistical Manual of Mental Disorders, sometimes known as the psychiatrist's "bible," saying that patients deserve better.
The change won't alter the way patients get diagnosed and treated in the clinic -- at least not for many years. Instead, researchers seeking to study mental disorders with National Institute of Mental Health (NIMH) funding will be required to look at patients across traditional diagnoses, rather than limiting their studies to a single DSM diagnosis such as depression, for example.
"Studies of biomarkers for 'depression' might begin by looking across many disorders with anhedonia or emotional appraisal bias or psychomotor retardation to understand the circuitry underlying these symptoms," NIMH director Thomas Insel wrote in a statement.
The DSM's fifth revision, the DSM-5, is due out in May. The book, published by the American Psychiatric Association, classifies mental disorders, and the revisions have spurred controversy. Particular disorders, such as sexual fetishes, are contested by those who would like to see them removed from the book and those who would like to see those diagnoses remain available.
Compared with the NIMH's shift, however, the DSM changes are minor. The agency is looking to improve the way mental disorders are identified in general.
"Unlike our definitions of ischemic heart disease, lymphoma or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure," Insel wrote.
As an alternative, the NIMH is launching the Research Domain Criteria Project. The goal, according to the agency, is "to transform diagnosis by incorporating genetics, imaging, cognitive science and other levels of information to lay the foundation for a new classification system."
The decade-long project will require researchers to include patients across DSM categories, or to subdivide the categories, when conducting research trials.
"We need to begin collecting the genetic, imaging, physiologic and cognitive data to see how all the data - not just the symptoms - cluster and how these clusters relate to treatment response," Insel wrote.
The agency acknowledged that such a shift will be a challenge in a time of limited funding and budget cuts, but said that patients should welcome the step toward better diagnosis and understanding of mental disorders.
- Top 10 Controversial Psychiatric Disorders
- Hot Stuff? 10 Unusual Sexual Fixations
- Top 10 Mysteries of the Mind
Also on HuffPost:
New Advice On Prostate Cancer Screening
This year, the U.S. Preventive Services Task Force <a href="http://www.npr.org/blogs/health/2012/05/21/153234671/all-routine-psa-tests-for-prostate-cancer-should-end-task-force-says">recommended <em>against</em> routine prostate cancer screening</a> for men of all ages, noting its small benefits compared to the harms, published in the <em>Annals of Internal Medicine</em>. "We think the <a href="http://www.npr.org/blogs/health/2012/05/21/153234671/all-routine-psa-tests-for-prostate-cancer-should-end-task-force-says">benefit is very small</a>," Dr. Michael LeFevre, a member of the task force, told NPR's Shots blog. "Our range is between zero and one prostate cancer death avoided for every thousand men screened," which is minuscule compared to lives saved for screenings for conditions like colorectal cancer. A study published at the beginning of the year in the <em>Journal of the National Cancer Institute</em> seemed to back up the recommendations, noting that routine prostate cancer screening didn't seem to make a <a href="http://www.huffingtonpost.com/2012/01/06/prostate-cancer-screening-psa-test-deaths-men_n_1190558.html">difference in the risk of dying from prostate cancer</a>, Reuters reported. However, the American Society of Clinical Oncology issued advice after the USPSTF's recommendation, saying that whether a man gets routine prostate cancer screening should <a href="http://www.huffingtonpost.com/2012/07/17/prostate-cancer-screening-test-man-life-expectancy_n_1679499.html">depend on his life expectancy</a>. For example, men who aren't expected to live more than another 10 years should be discouraged from PSA testing, the Associated Press reported.
PSA Testing Could Mean Fewer Cases Of Deadly Prostate Cancer
To add more to the research on prostate cancer screening, a study in the journal <em>Cancer</em> showed that routine PSA testing is linked with 17,000 fewer cases of the deadliest form of prostate cancer. "By not <a href="http://www.webmd.com/prostate-cancer/news/20120730/study-psa-testing-cuts-worst-prostate-cancers">using PSA tests</a> in the vast majority of men, you have to accept you are going to increase very serious metastatic disease threefold," study researcher Dr. Edward Messing, M.D., the chief of urology at the University of Rochester Medical Center, told WebMD. Specifically, researchers calculated that without routine prostate cancer screenings through PSA testing, 25,000 men would have been diagnosed with <a href="http://www.webmd.com/prostate-cancer/news/20120730/study-psa-testing-cuts-worst-prostate-cancers">metastatic prostate cancer</a> (a deadly form of prostate cancer where it has spread beyond the prostate to elsewhere in the body) in 2008, compared with the 8,000 who were actually diagnosed with metastatic prostate cancer that year, WebMD reported.
Working The Night Shift Could Raise Your Risk
<a href="http://www.huffingtonpost.com/2012/10/25/night-shift-prostate-cancer-health_n_2003392.html">Working the night shift</a> is associated with a 2.77-times increased risk of prostate cancer, according to a study in the <em>American Journal of Epidemiology</em>. The study, conducted by Canadian researchers included 3,137 men with cancer and 512 men without cancer. The researchers also found that <a href="http://www.huffingtonpost.com/2012/10/25/night-shift-prostate-cancer-health_n_2003392.html">working the night shift</a> raised the risk of lung, colon, bladder, rectal and pancreatic cancers, as well as non-Hodgkin's lymphoma.
Surgery May Not Be The Best Option For Everyone With Prostate Cancer
Surgery may not always be the best option for men whose prostate cancer is detected with an elevated PSA (prostate-specific antigen) level, according to a study in the <em>New England Journal of Medicine</em>. For men with early prostate cancer who received a <a href="http://abcnews.go.com/Health/ProstateCancer/surgery-rarely-best-prostate-cancer-study-suggests/story?id=16805902#.UJrg9m_A_kh">radical prostatectomy</a> (prostate-removal surgery), 47 percent died after 12 years, while 49.9 percent of men who just underwent observation died after 12 years, ABC News reported. Plus 81 percent of men who underwent the radical prostatectomy <a href="http://www.webmd.com/prostate-cancer/news/20120718/prostate-cancer-surgery-may-not-always-up-survival">experienced erectile dysfunction</a> in the two years following, and urinary incontinence plagued 17 percent of the men, WebMD reported. However, ABC News did note that men whose <a href="http://abcnews.go.com/Health/ProstateCancer/surgery-rarely-best-prostate-cancer-study-suggests/story?id=16805902#.UJrg9m_A_kh">PSA scores were extremely high</a> -- above 10 -- benefited from receiving surgery, indicating that the study may suggest rather <em>which</em> men may benefit most from receiving a radical prostatectomy for their prostate cancer.
Aspirin Could Help Prostate Cancer Patients Live Longer
Prostate cancer patients who <a href="http://www.nytimes.com/2012/08/28/health/research/regular-aspirin-use-may-aid-prostate-cancer-recovery-study-finds.html">take aspirin</a> could cut their risk of dying from the disease, Harvard researchers reported this year. <em>The New York Times</em> reported on the study, published in the <em>Journal of Clinical Oncology</em>, which showed that taking aspirin cut in half the risk of <a href="http://www.nytimes.com/2012/08/28/health/research/regular-aspirin-use-may-aid-prostate-cancer-recovery-study-finds.html">dying of prostate cancer</a> over a decade -- 8 percent of aspirin-nontakers died, compared with 3 percent of aspirin-takers.
Circumcision Could Affect Risk
Circumcision -- or the removal of a man's foreskin before he has sex for the first time -- is linked with a <a href="http://www.huffingtonpost.com/2012/03/12/circumcision-prostrate-cancer_n_1339047.html">lower risk of developing prostate cancer</a>, Fred Hutchinson Cancer Research Center scientists found this year. The findings, published in the journal <em>Cancer</em>, shows that prostate cancer risk for <a href="http://www.huffingtonpost.com/2012/03/12/circumcision-prostrate-cancer_n_1339047.html">men who are circumcised</a> before the first time they have sex is 15 percent lower, compared with uncircumcised men. While Dr. Andrew Freedman, who is on the American Academy of Pediatrics' circumcision task force but was not involved in the study, found the findings thought-provoking, he told HuffPost in an earlier article that "this kind of epidemiological research -- how A affects B, and B affects C -- is very difficult to do and makes it very difficult to account for confounding variables."
Pan-Fried Meat Could Raise Risk
Including <a href="http://www.huffingtonpost.com/2012/08/20/pan-fried-meat-cancer-prostate-_n_1798970.html">pan-fried meat</a> in your weekly meal rotations is linked with a higher risk of prostate cancer, University of Southern California researchers found. Specifically, men who eat one-and-a-half servings of red meat that's been pan-fried each week have a 30 percent <a href="http://www.huffingtonpost.com/2012/08/20/pan-fried-meat-cancer-prostate-_n_1798970.html">increased risk of advanced prostate cancer</a>. And men who eat two-and-a-half servings of the food have a 40 percent increased risk. Hamburger meat in particular -- compared with a red meat like steak -- seemed linked with the increased risk, according to the <em>Carcinogenesis</em> study. And while not a red meat, pan-fried poultry also seemed linked with the <a href="http://www.huffingtonpost.com/2012/08/20/pan-fried-meat-cancer-prostate-_n_1798970.html">increased prostate cancer risk</a> (while <em>baked</em> poultry was associated with a lower prostate cancer risk).
Genetic 'Signatures' Could Predict Aggressive Disease
Genes could hold a clue to who will go on to <a href="http://www.huffingtonpost.com/2012/10/09/prostate-cancer-genetic-signatures-aggressive-tumors_n_1949724.html">develop aggressive prostate cancer</a>, researchers found this year. Reuters reported on the <em>Lancet Oncology</em> study, showing aggressive tumors might be able to be predicted by two <a href="http://www.huffingtonpost.com/2012/10/09/prostate-cancer-genetic-signatures-aggressive-tumors_n_1949724.html">genetic "signatures</a>": <blockquote>Researchers in Britain and the United States found that by reading the patterns of genes switched on and off in blood cells, they could accurately detect which advanced prostate cancer patients had the worst survival rates.</blockquote>
Blood Pressure Could Affect Risk Of Dying From Prostate Cancer
The risk of dying from prostate cancer is higher if you also<a href="http://www.huffingtonpost.co.uk/2012/10/23/blood-pressure-prostate-cancer-deaths_n_2004582.html?just_reloaded=1"> have high blood pressure</a>, European researchers found. Specifically, hypertension was linked with a 62 percent increased risk of dying for people with prostate cancer. "When we looked to see if the metabolic factors are related to an increased risk of getting or dying from prostate cancer we found a relationship with <a href="http://www.huffingtonpost.co.uk/2012/10/23/blood-pressure-prostate-cancer-deaths_n_2004582.html?just_reloaded=1">death from the disease and high blood pressure</a>," study researcher Christel Haggstrom, of Umea University, told HuffPost UK. "There was also a link to high BMI but blood pressure had the strongest association to increased risk. The results for BMI are in line with previous findings in large studies."
Green Tea Is Good
Research presented at the annual meeting of the American Association for Cancer Research this year showed that drinking green tea could <a href="http://www.eurekalert.org/pub_releases/2012-10/aafc-gtr101112.php">help ward off inflammation</a> in men with prostate cancer who are about to undergo prostate-removal surgery. "Our study showed that <a href="http://www.eurekalert.org/pub_releases/2012-10/aafc-gtr101112.php">drinking six cups of green tea</a> affected biomarkers in prostate tissue at the time of surgery," study researcher Susanne M. Henning, Ph.D., R.D., of the David Geffen School of Medicine at the University of California Los Angeles, said in a statement. "This research offers new insights into the mechanisms by which green tea consumption may reduce the risk for prostate cancer by opposing processes such as inflammation, which are associated with prostate cancer growth."