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The absurdity of the latent disease model in mental health: 10,130,814 ways to have a DSM-5-TR psychological disorder.

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Title: The absurdity of the latent disease model in mental health: 10,130,814 ways to have a DSM-5-TR psychological disorder.
Authors: Borgogna, Nicholas C., Owen, Tyler, Aita, Stephen L.
Source: Journal of Mental Health. Aug2024, Vol. 33 Issue 4, p451-459. 9p.
Subjects: Psychiatric diagnosis, Statistical models, Bipolar disorder, Mental health, Mental illness, Research evaluation, Classification of mental disorders, Symptoms
Abstract: Background: Latent disease classification is currently the accepted approach to mental illness diagnosis. In the United States, this takes the form of the Diagnostic and Statistical Manual of Mental Disorders-5-Text Revision (DSM-5-TR). Latent disease classification has been criticized for reliability and validity problems, particularly regarding diagnostic heterogeneity. No authors have calculated the scope of the heterogeneity problem of the entire DSM-5-TR. Aims: We addressed this issue by calculating the unique diagnostic profiles that exist for every DSM-5-TR diagnosis. Methods: We did this by applying formulas previously used in smaller heterogeneity analyses to all diagnoses within the DSM-5-TR. Results: We found that there are 10,130,814 ways to be diagnosed with a mental illness using DSM-5-TR criteria. When specifiers are considered, this number balloons to over 161 septillion unique diagnostic presentations (driven mainly by bipolar II disorder). Additionally, there are 1,951,065 ways to present with psychiatric symptoms, yet not meet diagnostic criteria. Conclusions: Latent disease classification leads to considerable heterogeneity in possible presentations. We provide examples of how latent disease classification harms research and treatment programs. We echo recommendations for the dismissal of latent disease classification as a mental illness diagnostic program. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Mental Health is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: The absurdity of the latent disease model in mental health: 10,130,814 ways to have a DSM-5-TR psychological disorder.
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Mental+Health%22">Journal of Mental Health</searchLink>. Aug2024, Vol. 33 Issue 4, p451-459. 9p.
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  Data: <searchLink fieldCode="DE" term="%22Psychiatric+diagnosis%22">Psychiatric diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+models%22">Statistical models</searchLink><br /><searchLink fieldCode="DE" term="%22Bipolar+disorder%22">Bipolar disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+health%22">Mental health</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+illness%22">Mental illness</searchLink><br /><searchLink fieldCode="DE" term="%22Research+evaluation%22">Research evaluation</searchLink><br /><searchLink fieldCode="DE" term="%22Classification+of+mental+disorders%22">Classification of mental disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Symptoms%22">Symptoms</searchLink>
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  Label: Abstract
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  Data: Background: Latent disease classification is currently the accepted approach to mental illness diagnosis. In the United States, this takes the form of the Diagnostic and Statistical Manual of Mental Disorders-5-Text Revision (DSM-5-TR). Latent disease classification has been criticized for reliability and validity problems, particularly regarding diagnostic heterogeneity. No authors have calculated the scope of the heterogeneity problem of the entire DSM-5-TR. Aims: We addressed this issue by calculating the unique diagnostic profiles that exist for every DSM-5-TR diagnosis. Methods: We did this by applying formulas previously used in smaller heterogeneity analyses to all diagnoses within the DSM-5-TR. Results: We found that there are 10,130,814 ways to be diagnosed with a mental illness using DSM-5-TR criteria. When specifiers are considered, this number balloons to over 161 septillion unique diagnostic presentations (driven mainly by bipolar II disorder). Additionally, there are 1,951,065 ways to present with psychiatric symptoms, yet not meet diagnostic criteria. Conclusions: Latent disease classification leads to considerable heterogeneity in possible presentations. We provide examples of how latent disease classification harms research and treatment programs. We echo recommendations for the dismissal of latent disease classification as a mental illness diagnostic program. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Journal of Mental Health is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1080/09638237.2023.2278107
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        Text: English
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      – SubjectFull: Bipolar disorder
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      – SubjectFull: Classification of mental disorders
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              Text: Aug2024
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