A Transdiagnostic Approach to Mental Health Care

Transdiagnostic Approaches to Mental Healthcare

Mental health conditions such as posttraumatic stress disorder (PTSD) or major depressive disorder (MDD) are typically diagnosed based on specific criteria outlined in diagnostic manuals like the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD).¹ These criteria provide an organizing principle for diagnosis and assessment.^1,2 However, people diagnosed with different conditions may have overlapping symptoms.^1,3 For example, schizophrenia, PTSD, and MDD can all present with sleep disturbances and difficulty concentrating.^4,5 While these criteria are useful for diagnosis and assessment, this approach focuses on symptom checklists. It doesn't consider the different biological causes or the heterogeneity within patient populations.^1,3,6

A transdiagnostic approach considers shared symptoms that span different diagnoses.^3,7 For instance, instead of focusing on the specific DSM criteria for PTSD (e.g. intrusive memories, flashbacks, hypervigilance),⁸ a therapist might use techniques like cognitive behavioral therapy (CBT) to address negative thought patterns that contribute to anxiety and depression,⁹ regardless of the specific diagnosis (e.g. PTSD vs. MDD). Similarly, when social withdrawal is a symptom, a therapist could implement social skills training, a technique applicable to various conditions with social skill deficits.¹⁰

Future Directions: Refining and Expanding Transdiagnostic Care

Mental health research on transdiagnostic approaches is in its early stages but gaining momentum.¹ Further research into the specific mechanisms underlying shared symptoms across conditions is needed.¹¹ This knowledge can inform the development of more targeted interventions tailored to different symptom clusters. Additionally, incorporating transdiagnostic approaches into therapist training and clinical practice guidelines has the potential to lead to more efficient, effective, and potentially cost-effective treatment for a wider range of mental health challenges.^1,12,13

Further reading

• Insel T, et al. Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry 2010;167:748–751.
  The article discusses the Research Domain Criteria (RDoC) project, which aims to create a new classification framework for research on mental health conditions. The project focuses on incorporating data on pathophysiology, such as genomics and neuroscience, to improve treatment outcomes and provide a better match between research findings and clinical decision-making.

• Kotov R, et al. The Hierarchical Taxonomy of Psychopathology (HiTOP): a dimensional alternative to traditional nosologies. J Abnorm Psychol 2017;126:454–477.
  This paper introduces the Hierarchical Taxonomy of Psychopathology (HiTOP) system, a dimensional alternative to traditional classifications of mental health conditions, and discusses its potential implications for research and clinical applications.

SC-US-77219

SC-CRP-16425

August 2024