IMAGINE you are a doctor before the advent of modern medical tests and your patient is gasping for breath. Is it asthma, a chest injury, or are they having a heart-attack? You don’t know and have no idea how best to help them.
Some would argue that’s what it’s like for doctors trying to diagnose mental health problems today. There are no blood tests or brain scans for mental illnesses so diagnoses are subjective and unreliable.
The issue came to a head one year ago this month, with the latest edition of psychiatry’s “bible”, the Diagnostic and Statistical Manual of Mental Disorders. The US National Institute for Mental Health (NIMH) said the DSM-5 had so many problems we effectively need to tear it up and start again. The way forward, it said, is a new research program to discover the brain problems that underlie mental illnesses.
That research is now taking off. The first milestone came earlier this year, when the NIMH published a list of 23 core brain functions and their associated neural circuitry, neurotransmitters and genes – and the behaviors and emotions that go with them (see “The mind’s 23 building blocks”). Within weeks, the first drug trials conceived and funded through this new program will begin.