[cassowary37]

I'd be curious to hear you define biologically valid. The heritability (variance explained by inherited features) for those diagnoses ranges from 0.3-0.8 - greater than many other medical disorders - and for many of them there are identified genetic variants. Maybe that's some of the 'exciting research' you allude to?

I agree that they are used as heuristics - and indeed were developed to be heuristics, dating back to the RDC.

Psych attending

[outlace]

Perhaps I should have said biologically meaningful. Yes ASD, schizophrenia, bipolar and ADHD are heritable at around 0.8, impressive. But there's also a good amount of research showing that mental illness in any form is correlated and there is a "p factor" that seems to predispose people to mental illness in general. There could be many possible genetic variations that lead to the same DSM diagnosis. Similarly multiple neural derangements can lead to the same set of symptoms. And research based on brain imaging (e.g. https://www.nature.com/articles/s41467-018-05317-y) suggests that our DSM diagnoses are probably not mapping reliably onto underlying brain dynamics. Plus, if I just randomly throw together a set of symptoms e.g. {back pain, chronic bloating, insomnia}, I wouldn't be surprised if it was heritable at 0.3 or above given that whatever genes are involved are going to get passed down and often genes sit next to each other on the same chromosome etc.

The exciting research I care about is more along the lines of < https://www.ncbi.nlm.nih.gov/pubmed/30696271 > where we observe neural dynamics, hypothesize causality, intervene with TMS or other focal neuromodulatory tech, and see if in fact region A is causally linked to outcome B, or if neural dynamical state A is causally linked to outcome B.

I also meant that the DSM is biologically unreliable because it is only symptom clusters, and we cannot intervene at the level of symptoms, you have to intervene at the level of pathology. Symptoms are not pathology. It's the brain that is experiencing some pathology, so we need to ascertain the brain pathology and intervene at that level, and DSM, as noted by brain imaging studies, does not seem to reliably map onto that biology.

Aside, are you involved in software engineering? What brings you to HN?