Perils of Pragmatic Psychiatry: How We Can Do Better

Abstract

Etiologic and pathophysiologic understanding of psychiatric disorders is still in early stages. Psychiatric diagnoses are often based on less reliable and inconsistent symptoms, rather than biological markers. Although standard psychiatric diagnostic systems and criteria exist for many disease processes, the imprecise utilization of such diagnostic concepts, by many practitioners, lead to unfortunate clinical consequences. For a variety of reasons, many significant advances in neuroscience, pre-clinical studies, and phase 2 proof-of-concept studies have not been further studied or validated in large-scale trials. Thus, they have not translated to routine clinical practice. Furthermore, many