Working towards a new psychiatry - neuroscience, technology and the DSM-5

In the main, medicine has progressed substantially in recent years due to technological advances that have arguably enhanced methods to analyse research data, improved diagnostic techniques, and enabled more effective therapeutics. Such advancements are also being employed increasingly in psychiatry; in particular, progress in neuroimaging and other neurophysiological techniques, developments in behavioural sciences and psychotherapies, and developments in psychiatric genetics have all contributed to knowledge of mental illnesses. However, we must ask if, and in what ways these developments actually have affected the science, practice and clinical value of psychiatry. In addition, psychiatry is also confronting increasing diversity in socio-cultural values, norms and perspectives. The constructs of normality and abnormality, mental health and disorder, and the need for varying types of preventive and therapeutic interventions are undergoing iterative change. In part, this is reflected in, and influenced by the fifth edition of the Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association, which upon release in spring of 2013, is hoped to instantiate greater consistency, and improve the ways that psychiatric disorders are classified and diagnosed [1], and lead to a greater conformity of psychiatric therapeutics. Yet, we must ask how these changes will affect the profession and practice on the world-stage, given an increasing trend toward pluralisation, and a need to address multi-cultural values and expectations about the nature of mental health and goals of psychiatric practice. Thus, we posit that the profession and practice of psychiatry is poised for evolution, and there is a need to review how current practices should be regarded, revised, implemented, and monitored.Such re-assessment and revision will be important as worldwide social changes prompt new challenges and opportunities in psychiatric research and practice: international ethni