title: Charting the landscape of priority problems in psychiatry, part 1: classification and diagnosis.
abstract: Contemporary psychiatry faces major challenges. Its syndrome-based disease classification is not based on mechanisms and does not guide treatment, which largely depends on trial and error. The development of therapies is hindered by ignorance of potential beneficiary patient subgroups. Neuroscientific and genetics research have yet to affect disease definitions or contribute to clinical decision making. In this challenging setting, what should psychiatric research focus on? In two companion papers, we present a list of problems nominated by clinicians and researchers from different disciplines as candidates for future scientific investigation of mental disorders. These problems are loosely grouped into challenges concerning nosology and diagnosis (this Personal View) and problems related to pathogenesis and aetiology (in the companion Personal View). Motivated by successful examples in other disciplines, particularly the list of Hilbert's problems in mathematics, this subjective and eclectic list of priority problems is intended for psychiatric researchers, helping to re-focus existing research and providing perspectives for future psychiatric science.
authors.affiliation: Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland; Wellcome Trust Centre for Neuroimaging, University College London, London, UK; Max Planck Institute for Metabolism Research, Cologne, Germany. Electronic address: stephan@biomed.ee.ethz.ch.
authors.forename: Klaas E
authors.initials: KE
authors.lastname: Stephan
authors.affiliation: Wellcome Trust Centre for Neuroimaging, University College London, London, UK; Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.
authors.forename: Dominik R
authors.initials: DR
authors.lastname: Bach
authors.affiliation: Department of Psychiatry, University of Cambridge, Cambridge, UK.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Fletcher
authors.affiliation: Wellcome Trust Centre for Human Genetics, Oxford University, Oxford, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Flint
authors.affiliation: Brown Institute for Brain Science, Brown University, Providence, RI, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Frank
authors.affiliation: Wellcome Trust Centre for Neuroimaging, University College London, London, UK.
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Friston
authors.affiliation: Department of Psychiatry, Humboldt University, Berlin, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Heinz
authors.affiliation: Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland; Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.
authors.forename: Quentin J M
authors.initials: QJM
authors.lastname: Huys
authors.affiliation: MRC Centre for Neuropsychiatric Genetics and Genomics and Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Owen
authors.affiliation: Department of Translational Research in Psychiatry, Max Planck Institute for Psychiatry, Munich, Germany; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Elisabeth B
authors.initials: EB
authors.lastname: Binder
authors.affiliation: Gatsby Computational Neuroscience Unit, University College London, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Dayan
authors.affiliation: Department of Psychiatry, University of Edinburgh, Edinburgh, UK.
authors.forename: Eve C
authors.initials: EC
authors.lastname: Johnstone
authors.affiliation: Central Institute of Mental Health, University of Mannheim, Mannheim, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Meyer-Lindenberg
authors.affiliation: Wellcome Trust Centre for Neuroimaging, University College London, London, UK; Computational Psychiatry Unit, Virginia Tech Carilion Research Institute, Roanoke, VA, USA.
authors.forename: P Read
authors.initials: PR
authors.lastname: Montague
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schnyder
authors.affiliation: Center for Neural Science, New York University, New York, NY, USA; Institute of Brain and Cognitive Science, NYU Shanghai, Shanghai, China.
authors.forename: Xiao-Jing
authors.initials: XJ
authors.lastname: Wang
authors.affiliation: Queensland Medical Research Institute, Brisbane, QLD, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Breakspear
mesh_terms: D006801:Humans; D001523:Mental Disorders / Q000145:classification* / Q000175:diagnosis*; D011570:Psychiatry; D012106:Research