Mental health progress requires causal diagnostic nosology and scalable causal discovery

Glenn N. Saxe, Leonard Bickman, Sisi Ma, Constantin Aliferis

Research output: Contribution to journalReview articlepeer-review


Nine hundred and seventy million individuals across the globe are estimated to carry the burden of a mental disorder. Limited progress has been achieved in alleviating this burden over decades of effort, compared to progress achieved for many other medical disorders. Progress on outcome improvement for all medical disorders, including mental disorders, requires research capable of discovering causality at sufficient scale and speed, and a diagnostic nosology capable of encoding the causal knowledge that is discovered. Accordingly, the field’s guiding paradigm limits progress by maintaining: (a) a diagnostic nosology (DSM-5) with a profound lack of causality; (b) a misalignment between mental health etiologic research and nosology; (c) an over-reliance on clinical trials beyond their capabilities; and (d) a limited adoption of newer methods capable of discovering the complex etiology of mental disorders. We detail feasible directions forward, to achieve greater levels of progress on improving outcomes for mental disorders, by: (a) the discovery of knowledge on the complex etiology of mental disorders with application of Causal Data Science methods; and (b) the encoding of the etiological knowledge that is discovered within a causal diagnostic system for mental disorders.

Original languageEnglish (US)
Article number898789
JournalFrontiers in Psychiatry
StatePublished - Nov 15 2022

Bibliographical note

Funding Information:
This work was supported by the National Institute for Mental Health (R01MH119114), the Substance Abuse and Mental Health Services Administration (U79SM080049), and the National Center for Advancing Translation Science (UL1TR002494).

Publisher Copyright:
Copyright © 2022 Saxe, Bickman, Ma and Aliferis.


  • causality
  • diagnosis
  • etiology
  • mental health
  • methodology
  • outcomes
  • psychiatry

PubMed: MeSH publication types

  • Journal Article
  • Review


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