Schizophrenia Research ForumWebinarMay 28, 2014

Bruce N. Cuthbert, Ph.D.

Director, Division of Adult Translational Research

National Institute of Mental Health

Toward Precision Medicine for Mental Disorders:NIMH Research Domain Criteria (RDoC)

Disclosures

• Dr. Cuthbert is a Title 42 federal employee who is required to disclose all financial holdings as public record, and has no outside activities to disclose.

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Schizophrenia: A complex syndrome

• Highly heterogeneous

• Michael Owen: “There is no such thing as schizophrenia.”

• Psychosis, hallucinations in other disorders

• Research task: Study the individual differences to find more precise diagnosis and intervention

Polygenic Risks for Mental Disorders

Cross-Disorder group of the PGC,Lancet, 2013

Neurodevelopment and Plasticity

Neurodevelopment

Environment

Age

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NIMH Strategic Plan: Goal 1.4

• “Develop, for research purposes, new ways of classifying mental disorders based on dimensions of observable behavior and neurobiological measures.”

[Symptoms]• Elevated Stress

• Heightened threat reactivity

• Abnormalities in reward-related activity• Substance abuse

• Hippocampus: encoding functions• Perceptual aberrations

• Social withdrawal• Need for social relationships

• Disruptions in network connectivity• Dysfunctions in arousal/activation systems

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RDoC: Quick Summary

• A framework to study mechanisms that cut across traditional disorder boundaries

• Dimensional approach – understand transitions from normal to mild, moderate, severe dysfunction

• Will inform, not compete with, future versions of DSM and ICD

• Toward personalized medicine in psychiatry, consistent with other areas of medicine

• http://www.nimh.nih.gov/research-priorities/rdoc/index.shtml