Psychiatric Classification Research
Why diagnosis doesn't match biology, and what alternatives exist.
The problem
Current psychiatric diagnosis (DSM-5, ICD-11) has a validity crisis: categories don't map to biology, same diagnosis covers vastly different conditions, and treatment remains trial-and-error despite 40+ years of "scientific" classification.
- STAR*D trial: Only 30% remission with first antidepressant
- Depression (MDD): 227 possible symptom combinations under one label
- 50%+ comorbidity rates suggest categories are arbitrary, not natural
- Genetic studies find same variants across schizophrenia, bipolar, autism
Primary sources
Diagnostic systems
- DSM-5-TR (APA, 2022) — Official reference | Local overview
- ICD-11 Chapter 6 (WHO, 2022) — Browser | DSM-5 comparison
Research frameworks
- RDoC (NIMH, 2009-present) — Framework | Local summary
- HiTOP (Krueger et al.) — Hierarchical taxonomy based on symptom co-occurrence
Clinical guidelines
- NICE Guidelines (NHS England) — Mental health | Depression | PTSD
- APA Practice Guidelines — Current guidelines | Depression
Novel framework: The 7
A body-based, dimensional alternative to categorical diagnosis. Instead of "which disorder bucket?", ask "where are you on each dimension?"
The 7 characteristics
Key principles
- No position is inherently "right" — context determines whether a position serves you
- Both ends can be problematic — not "more is better"
- States, not traits — where you ARE, not who you ARE
- You define the target — not a norm, not a professional
Full framework | Self-assessment | Disorder mapping | Why this beats DSM/ICD
Raw data
All source files available for download/fork:
Legacy systems
- sources-index.json — Structured reference index
- dsm5-overview.md — DSM-5 structure and categories
- dsm5-classification-changes.md — Evolution from DSM-IV
- icd11-vs-dsm5-comparison.md — Key differences
- rdoc-framework.md — RDoC domains and approach
- psychiatric-classification-100yr-landscape.md — Historical synthesis
The 7 framework
- fingerprint-framework-the-7.md — Core definitions
- fingerprint-self-assessment.md — Assessment questions
- fingerprint-body-map.md — Visual representation
- fingerprint-vs-legacy-buckets.md — Comparison with DSM/ICD
- fingerprint-disorder-mapping.md — Disorders → fingerprints
- fingerprint-index.json — Structured index
Historical analysis
100-year landscape report traces:
- Kraepelin's biological classification (1920s)
- Psychoanalytic dominance (1930s-1970s)
- DSM-III reliability revolution (1980)
- Validity crisis (2010s-present)
- Emerging alternatives: RDoC, HiTOP, network approach
Open questions
- How to operationalize The 7 for clinical use?
- Can fingerprints guide treatment selection better than diagnosis?
- How to handle insurance requirements for categorical diagnosis?
- What interventions map to each characteristic?
- How does The 7 compare empirically to HiTOP/RDoC?
Contribute
- Add interventions: What moves each characteristic?
- Submit research: Validation, evidence, references
- Translate: Framework in other languages
- Build tools: Apps, visualizations, interfaces
Status
active Primary sources aggregated. Historical synthesis complete. The 7 framework defined. Intervention mapping in progress.