In addition to the work done by the research agenda groups, the need was clear for research review and planning that would focus specifically on discrete diagnostic topics. Under the direction of Executive Director Darrel A. Regier, M.D., M.P.H., the American Psychiatric Institute for Research and Education (APIRE) planned a series of conferences that would zero in on diagnostic questions that clinical experience and recent research advances had pegged either as problematic in practice, or ripe for revision based on recent scientific advances. These issues included:
The extent, and clinical implications, of the frequent comorbidity of major depressive disorder and generalized anxiety;
The factors that may commonly underlie disorders with psychotic features such as bipolar mood disorder, schizophrenia, and major depression with psychotic features;
The relationships of several disorders that affect behavior early in a child’s life, such as Attention-Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder, and how they are manifested through adolescence and into adult life;
Recent research that has begun to identify specific brain circuits implicated in a range of stress-related and fear-based mental disorders, such as post-traumatic stress disorder, phobias, and panic disorders;
The origins and interrelationships of cognitive impairments and full-blown dementias that appear with increasing frequency in late life.
In 2003, APIRE was awarded a five-year research conference grant to address these and other questions, with joint funding from the National Institute of Mental Health (NIMH), the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The Scientific Steering Committee of this Cooperative Agreement included representatives from APIRE, the World Health Organization (WHO), and each of the NIH funding institutes. This “future of psychiatric diagnosis” conference series has entailed the formation of 12 work groups, each of whose efforts culminate in a three-day conference involving roughly 25 research leaders from around the world. On the basis of their critical reviews of the scientific studies of their assigned topics, participating experts were given the task of generating recommendations for short-term and longer-term research that will inform and guide future revisions of DSM.
As envisioned by APA, WHO, and NIH, the conference series would aim to stimulate the empirical research necessary to allow informed decision making on crucial diagnostic deficiencies in DSM-IV (and potentially, ICD-10), and to promote the international collaboration necessary to increase the likelihood of developing a compatible DSM-V and ICD-10. Under these broad objectives, APIRE and its partners at WHO and NIH, planned that each of the conferences would have three general tasks:
To present reviews of current data relevant to the specific diagnostic question(s) that would be the focus of the conference;
To develop a research agenda for the design of studies that may significantly enhance the empirical data base necessary for resolving these diagnostic issues; and
To develop strategies to facilitate the collection and analysis of the relevant empirical data.
Given the vision of a system for classifying mental disorders that will be applicable across geographical and cultural boundaries, the APA/WHO/NIH Executive Steering Committee for the project attached high priority to assuring the participation of investigators from all parts of the world. Toward this end, each conference in the series had two co-chairs, drawn respectively from the U.S. and a country other than the U.S. Approximately half of the experts invited to serve on the work groups were from outside the U.S., and half of the conferences were convened outside the U.S.
The workgroups and conference series program included:
Research Planning Launch/Methods Conference (February 18-20, 2004)
Personality Disorders Conference (December 1-3, 2004)
Substance-Related Disorders Conference (February 14-17, 2005)
Stress-Induced and Fear Circuitry Disorders Conference (June 23-24, 2005)
Dementia Conference (September 15-17, 2005)
Deconstructing Psychosis (February 15-17, 2006)
Obsessive Compulsive Spectrum Disorders Conference (June 20-22, 2006)
Dimensional Aspects of Psychiatric Diagnosis (July 26-28, 2006)
Somatic Presentations of Mental Disorders (September 6-8, 2006)
Externalizing Disorders of Childhood (Attention-deficit/Hyperactivity Disorder, Conduct Disorder, Oppositional-Defiant Disorder, Juvenile Bipolar Disorder) (February 14-16, 2007)
Comorbidity of Depression and Generalized Anxiety Disorder (June 20-22, 2007)
Public Health Implications of Changes in Psychiatric Classification (September 25-28, 2007)
Autism and Other Pervasive Developmental Disorders Conference (February 3-5, 2008)
Proceedings from these conferences will serve as resource documents for work groups involved in the official DSM-5 revision process. As information about each conference becomes available, additional pages will be added to this site.