RDoC in historical perspective

Samuel Gershon’s reply to Martin M. Katz and Antonio E. Nardi’s comment

I agree with Marty Katz and Antonio Nardi that the etiology of mental disorders is not understood or adequately explained scientifically by any system discussed. Further, we do not have a range of pharmacotherapeutic agents that specifically and effectively treat any of our psychiatric disorders and the introduction of very many psychiatric medications has not contributed meaningfully to any of these questions. The situation of psychodynamic explanations and therapies has led us no further. Also, non- dynamic psychotherapies have a weak basis for efficacy in major psychiatric disorders. Yet oddly, the oldest therapeutic pharmacotherapeutic agent, Lithium, has been with us since its reintroduction for 65 years. During this period, we have defined its therapeutic profile and recently, Duffy and Grof have helped further in this definition by defining a group of manic-depressive patients that are responders vs. a group of non-responders and describing a genetic linkage in the responders. Thus, all possible techniques of looking and learning can contribute to the answer.

Reference:    

Duffy A, Horrocks J, Doucette S, Keown-Stoneman Ch, McCloskey S, Grof  P. The developmental trajectory of bipolar disorder. The British Journal of Psychiatry 2014; 204: 122-8.  

Samuel Gershon

May 21, 2015