“It is the very essence of our striving for understanding that, on the one hand, it attempts to encompass the great and complex variety of man’s experience, and that on the other, it looks for simplicity and economy in the basic assumptions. The belief that these two objectives can exist side by side is a matter of faith. Without such faith I could not have a strong and unshakable conviction about the independent value of knowledge.”
Current psychiatric diagnoses are based on the DSM (Diagnostic and Statistical Manual), a compendium of many different diagnostic listings, under multiple categories, arrived at based on clinical experience and expert consents (i.e. by committee deliberations). The DSM is used as a lingua franca among practitioners, for insurance billing purposes, and as a disease indication for FDA approval of drugs. In practice, most patients end up with multiple diagnoses, not only over time, but at the same time, suggesting than clinicians sense that there is a lack of clarity and an overlap between the different diagnostic categories in the DSM.
Over the last two decades we have worked on a simpler alternative, the tri-dimensional mental landscape, or Mindscape. The three dimensions are anxiety, mood, and cognition. Each individual if measured with rating scales or, more recently, with blood biomarker tests, can get x, y, z coordinates for the point in the Mindscape where she/he is at that moment in time. Over time, repeated measures can build a cloud out of these points. That cloud is a closer representation of who you are that trying to be squashed and fitted, unsuccessfully, in one or the other of the three dimensions, by a DSM label.
We have described this approach in papers and a book (Life and Mind).In practice, we have developed simple visual analog assessments to measure anxiety, mood and cognition, validated them against existing questionnaires, and rolled them out into an app (Life x Mind). So you can build your own Mindscape cloud at home, every day, on an app. Moreover, we developed blood biomarker tests for each of the three dimensions, that can be used to objectively build your Mindscape cloud, and for your doctor to understand the degree of comorbidity (load) on the three dimensions, and which medications would best fit the multiple things that you have. In practice, this integrative approach can be simpler, actionable, and comprehensive. We look forward to continue working hard to help deploy it in the real world, where it may help people get diagnosed and treated faster, easier, better.
Live. Happier. Longer.