RESUMO
Pese al éxito (o consenso) conseguido en la homogeneización de criterios clínicos por los sistemas de clasificación psiquiátrica categoriales (DSM y CIE), su validez y utilidad, clínica y en investigación, son cuestionables. En este artículo de revisión presentamos el marco Criterios de Investigación por Dominios (Research Domain Criteria, RDoC) como una alternativa para la investigación traslacional en psiquiatría. El marco de investigación traslacional RDoC sistematiza dianas y métodos de investigación en psiquiatría. RDoC parte de un catálogo de bases neurofuncionales de la conducta y plantea la psicopatología como la expresión fenotípica de las alteraciones en dichas funciones. Estas se clasifican en 5sistemas psicobiológicos. Los constructos funcionales se validan mediante evidencia proveniente de estudios básicos en 7 niveles de análisis: genes, moléculas, células, circuitos nerviosos, fisiología, conducta y autoinformes. Frente a los sistemas categoriales centrados en el diagnóstico, RDoC propone centrar el estudio de la psicopatología como correlato de alteraciones funcionales detectables, biológicas y comportamentales. RDoC es un marco de investigación que vincula el sustrato biológico con las manifestaciones fenotípicas, para llegar a una nosología psiquiátrica útil para guiar el tratamiento. Pese a que los hallazgos de RDoC no articulan un modelo concreto de guía para la práctica clínica, es un sistema de transición útil para crear hipótesis de investigación clínica, básica y epidemiológica
Despite the consensus achieved in the homogenization of clinical criteria by categorical psychiatric classification systems (DEM and CIE), they are criticized for a lack of validity and inability to guide clinical treatment and research. In this review article we introduce the Research Domain Criteria (RDoC) framework as an alternative framework for translational research in psychiatry. The RDOC framework systematizes both research targets and methodology for research in psychiatry. RDoC is based on a catalogue of neurobiological and neurocognitive evidence of behaviour, and conceives psychopathology as the phenotypic expression of alterations of functional domains that are classified into 5psychobiological systems. The RdoC framework also proposes that domains must be validated with evidence in 7levels of analysis: genes, molecules, cells, nerve circuits, physiology, behaviour and self-reports. As opposed to categorical systems focused on diagnosis, RDoC focuses on the study of psychopathology as a correlate of detectable functional, biological and behavioural disruption of normal processes. In order to build a useful psychiatric nosology for guiding clinical interventions, the RDoC research framework links the neurobiological basis of mental processes with phenotypical manifestations. Although the RDoC findings have not yet been articulated into a specific model for guiding clinical practice, they provide a useful transition system for creating clinical, basic and epidemiological research hypotheses
Assuntos
Humanos , Pesquisa Translacional Biomédica/tendências , Psiquiatria/tendências , Transtornos Mentais/classificação , Domínios Científicos , Padrões de Prática Médica/tendências , Manual Diagnóstico e Estatístico de Transtornos MentaisRESUMO
Despite the consensus achieved in the homogenization of clinical criteria by categorical psychiatric classification systems (DEM and CIE), they are criticized for a lack of validity and inability to guide clinical treatment and research. In this review article we introduce the Research Domain Criteria (RDoC) framework as an alternative framework for translational research in psychiatry. The RDOC framework systematizes both research targets and methodology for research in psychiatry. RDoC is based on a catalogue of neurobiological and neurocognitive evidence of behaviour, and conceives psychopathology as the phenotypic expression of alterations of functional domains that are classified into 5psychobiological systems. The RdoC framework also proposes that domains must be validated with evidence in 7levels of analysis: genes, molecules, cells, nerve circuits, physiology, behaviour and self-reports. As opposed to categorical systems focused on diagnosis, RDoC focuses on the study of psychopathology as a correlate of detectable functional, biological and behavioural disruption of normal processes. In order to build a useful psychiatric nosology for guiding clinical interventions, the RDoC research framework links the neurobiological basis of mental processes with phenotypical manifestations. Although the RDoC findings have not yet been articulated into a specific model for guiding clinical practice, they provide a useful transition system for creating clinical, basic and epidemiological research hypotheses.
