Interview with Dr Bruce Cuthbert - RDoC and its influence on 21st century psychiatric drug discovery

No satisfactory theory of the pathophysiology of mental disorders has been uncovered. Despite years of research, we still do not have enough of an understanding of the biological mechanisms of psychopathology to be able to move towards prevention or cure of mental disorders. A radical proposal to tackle this failure is the National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) initiative.

At the 30th international CINP congress in Seoul, Korea, we spoke with Dr Bruce Cuthbert, Acting Director of the NIMH, about the RDoC initiative and how it can support improved research into CNS disorders and their management.

RDoC is a new research framework for studying mental disorders. The framework consists of a matrix of functional constructs - concepts which represent specified dimensions of behaviour. These are characterized by many levels of information (from genomics to self-report). Constructs are grouped into higher-level domains of functioning - major systems of emotion, cognition, motivation and social behaviour. A key feature of RDoC is that it is a dynamic initiative - the matrix can be expanded with new research discoveries as these become available.

Dr Bruce Cuthbert described the overarching goal of RDoC - to understand mental disorders as deviations from the normal functioning of brain systems, rather than continuing with inadequate symptom-based definitions. We don’t yet know what an integrated multi-measurement diagnostic system looks like. Therefore, RDoC is not an alternative nosology - rather, it is a focused research initiative moving towards a new classification system.

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