Transforming diagnosis: Brain knowledge and the future of psychiatric nosology
(Université de Lausanne)
Paper short abstract:
Paper long abstract:
A few weeks before the publication of psychiatric manual DSM-5, in April 2013, Director of the NIMH Thomas Insel wrote in his blog that the patients suffering from mental disorders deserve better than a manual which validity is inadequate because not solidly founded on genetics and neuroscience. Widely publicized on the web, Insel's post advocated a new method introduced in 2009: « NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system ». RDoC aims at accelerating the translation of knowledge from basic research to clinical practice. Translational psychiatric neuroscience is at the heart of European and US research policies and deserve close attention from a social studies of science and medicine perspective because, I will argue in this paper, it is part of the new sociotechnical imaginaries (Jasanoff & Kim, 2009) of contemporary mental health systems. In this paper, I will study the needs, promises and critiques that translational neuroscientists face when dealing with mental disorders as an object of study. Drawing on expert interviews of clinicians-researchers and on a review of the literature on RDoC, I will explore the narratives of the future, and how the translation gap or lag appears in these narratives, together with its solutions (transforming diagnosis, better interdisciplinarity, knowledge brokering…). This paper proposes a sociology of translational psychiatric neuroscience which maps the envisioned futures incorporated in today brain science.