Poor Separation of Clinical Symptom Profiles by DSM-5 Disorder Criteria

Assessment of mental illness typically relies on a disorder classification system that is considered to be at odds with the vast disorder comorbidity and symptom heterogeneity that exists within and across patients. Patients with the same disorder diagnosis exhibit diverse symptom profiles and comor...

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Autores principales:	Jennifer Jane Newson, Vladyslav Pastukh, Tara C. Thiagarajan
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	diagnosis symptom profiles DSM-5 comorbidity heterogeneity depression Psychiatry RC435-571
Acceso en línea:	https://doaj.org/article/05a1fbfb73374d329a445cbe4a3491ea
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spelling	oai:doaj.org-article:05a1fbfb73374d329a445cbe4a3491ea2021-12-01T14:27:15ZPoor Separation of Clinical Symptom Profiles by DSM-5 Disorder Criteria1664-064010.3389/fpsyt.2021.775762https://doaj.org/article/05a1fbfb73374d329a445cbe4a3491ea2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fpsyt.2021.775762/fullhttps://doaj.org/toc/1664-0640Assessment of mental illness typically relies on a disorder classification system that is considered to be at odds with the vast disorder comorbidity and symptom heterogeneity that exists within and across patients. Patients with the same disorder diagnosis exhibit diverse symptom profiles and comorbidities creating numerous clinical and research challenges. Here we provide a quantitative analysis of the symptom heterogeneity and disorder comorbidity across a sample of 107,349 adult individuals (aged 18–85 years) from 8 English-speaking countries. Data were acquired using the Mental Health Quotient, an anonymous, online, self-report tool that comprehensively evaluates symptom profiles across 10 common mental health disorders. Dissimilarity of symptom profiles within and between disorders was then computed. We found a continuum of symptom prevalence rather than a clear separation of normal and disordered. While 58.7% of those with 5 or more clinically significant symptoms did not map to the diagnostic criteria of any of the 10 DSM-5 disorders studied, those with symptom profiles that mapped to at least one disorder had, on average, 20 clinically significant symptoms. Within this group, the heterogeneity of symptom profiles was almost as high within a disorder label as between 2 disorder labels and not separable from randomly selected groups of individuals with at least one of any of the 10 disorders. Overall, these results quantify the scale of misalignment between clinical symptom profiles and DSM-5 disorder labels and demonstrate that DSM-5 disorder criteria do not separate individuals from random when the complete mental health symptom profile of an individual is considered. Greater emphasis on empirical, disorder agnostic approaches to symptom profiling would help overcome existing challenges with heterogeneity and comorbidity, aiding clinical and research outcomes.Jennifer Jane NewsonVladyslav PastukhTara C. ThiagarajanFrontiers Media S.A.articlediagnosissymptom profilesDSM-5comorbidityheterogeneitydepressionPsychiatryRC435-571ENFrontiers in Psychiatry, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diagnosis symptom profiles DSM-5 comorbidity heterogeneity depression Psychiatry RC435-571
spellingShingle	diagnosis symptom profiles DSM-5 comorbidity heterogeneity depression Psychiatry RC435-571 Jennifer Jane Newson Vladyslav Pastukh Tara C. Thiagarajan Poor Separation of Clinical Symptom Profiles by DSM-5 Disorder Criteria
description	Assessment of mental illness typically relies on a disorder classification system that is considered to be at odds with the vast disorder comorbidity and symptom heterogeneity that exists within and across patients. Patients with the same disorder diagnosis exhibit diverse symptom profiles and comorbidities creating numerous clinical and research challenges. Here we provide a quantitative analysis of the symptom heterogeneity and disorder comorbidity across a sample of 107,349 adult individuals (aged 18–85 years) from 8 English-speaking countries. Data were acquired using the Mental Health Quotient, an anonymous, online, self-report tool that comprehensively evaluates symptom profiles across 10 common mental health disorders. Dissimilarity of symptom profiles within and between disorders was then computed. We found a continuum of symptom prevalence rather than a clear separation of normal and disordered. While 58.7% of those with 5 or more clinically significant symptoms did not map to the diagnostic criteria of any of the 10 DSM-5 disorders studied, those with symptom profiles that mapped to at least one disorder had, on average, 20 clinically significant symptoms. Within this group, the heterogeneity of symptom profiles was almost as high within a disorder label as between 2 disorder labels and not separable from randomly selected groups of individuals with at least one of any of the 10 disorders. Overall, these results quantify the scale of misalignment between clinical symptom profiles and DSM-5 disorder labels and demonstrate that DSM-5 disorder criteria do not separate individuals from random when the complete mental health symptom profile of an individual is considered. Greater emphasis on empirical, disorder agnostic approaches to symptom profiling would help overcome existing challenges with heterogeneity and comorbidity, aiding clinical and research outcomes.
format	article
author	Jennifer Jane Newson Vladyslav Pastukh Tara C. Thiagarajan
author_facet	Jennifer Jane Newson Vladyslav Pastukh Tara C. Thiagarajan
author_sort	Jennifer Jane Newson
title	Poor Separation of Clinical Symptom Profiles by DSM-5 Disorder Criteria
title_short	Poor Separation of Clinical Symptom Profiles by DSM-5 Disorder Criteria
title_full	Poor Separation of Clinical Symptom Profiles by DSM-5 Disorder Criteria
title_fullStr	Poor Separation of Clinical Symptom Profiles by DSM-5 Disorder Criteria
title_full_unstemmed	Poor Separation of Clinical Symptom Profiles by DSM-5 Disorder Criteria
title_sort	poor separation of clinical symptom profiles by dsm-5 disorder criteria
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/05a1fbfb73374d329a445cbe4a3491ea
work_keys_str_mv	AT jenniferjanenewson poorseparationofclinicalsymptomprofilesbydsm5disordercriteria AT vladyslavpastukh poorseparationofclinicalsymptomprofilesbydsm5disordercriteria AT taracthiagarajan poorseparationofclinicalsymptomprofilesbydsm5disordercriteria
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Poor Separation of Clinical Symptom Profiles by DSM-5 Disorder Criteria

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