RDoC  IN HISTORICAL PERSPECTIVE

SAMUEL GERSHON’S REPLY TO JOSE DE LEON’S COMMENT

I have read through this entire discussion and find that Dr. de Leon’s comments put all the input in perspective. However, the situation of research and clinical care in psychiatry is in a very difficult situation. We have the basic neurosciences making enormous advances in understanding basic nervous system mechanisms. However in the clinical arena we have some very basic difficulties. We have diagnostic systems that are not based on an understanding of etiology and a large number of marketed medications that have not been demonstrated to have specific effects on the totality of a psychiatric disorder, illness or syndrome. We have one lonely remarkable compound with established, limited and specific therapeutic effects clinically and in basic neural systems. Lithium, which reappeared 65 years ago does give us an opportunity to study and understand its basic and clinical effects.

Samuel Gershon

June 4, 2015