Penn to test criteria for guide to mental disorders

Psychiatric patients at the Hospital of the University of Pennsylvania will now have a helping hand to assist doctors nationwide in screening the mentally ill.

Named by the American Psychiatric Association as a national testing site, Penn will begin a 6-month trial period to evaluate widely used criteria for diagnosing mental disorders that affect millions of Americans.

The Diagnostic and Statistical Manual of Mental Disorders, published by the APA, represents the most authoritative source in the field of psychiatry, with its latest draft seeking to provide descriptions of symptoms to better diagnose mental disorders. Originally published in 1952, the DSM is in its fourth and most expansive revision, awaiting the trial studies conducted by Penn and ten other institutions.

Beginning this month, patients at Penn’s outpatient psychiatry clinic will be invited to participate in a study to assess criteria in diagnosing five specific mental disorders — general anxiety disorder, obsessive-compulsive disorder and hoarding, anxious depression, binge eating and personality disorders — three of which were not included in previous manuals.

“DSM drives a lot of what happens in psychiatry,” said Mahendra Bhati, the principal investigator for the DSM-5 trials at Penn. “It helps doctors prescribe medications and treatment, and has a tremendous amount of influence on society.”

From now until May, Penn doctors will recruit 300 patients to participate in a paid study. Two doctors will be assigned to one patient. The intent of the study is that the DSM should lead them to arrive at the same diagnosis for the patient’s disorder without relying on clinical intervention, such as the use of blood tests and body scans.

Penn’s selection as a DSM testing site comes after a decade-long public comment period, where 8,000 comments were submitted to the proposed DSM-5 draft and were reviewed by 600 experts in the field of mental health worldwide.

While the DSM has been published since the 1950s, Penn mood disorder specialist Marna Barrett said DSM-5 marks the first time the APA has invited clinicians to conduct trial tests.

“This allows a lot of practitioners at Penn to participate and be on the front line in actual revisions,” Barrett said.

Jordan Coello, a clinical research coordinator, pinpointed HUP’s great research facilities and access to diverse clinical population as factors that led to Penn’s selection.

The DSM has lately focused much of its attention to childhood disorders, but Penn will seek a new approach to diagnosing adult personality disorders outside of the better documented categories of depression and schizophrenia.

Coello stated that patients will come in for three rounds of two-hour interviews and participate in a self-report session as well as a final diagnostic interview.

With DSM-5’s publication date set for May 2013, psychiatrists look forward to the new findings as one of the most anticipated events.

“While the department at Penn is too big to be affected by Penn’s selection as a DSM site,” Bhati said, “the way we will be most influenced is when DSM-5 comes out in 2013, and clinicians, researchers, and patients will shift the way they think about mental illnesses.”

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