Darrel A Regier

Darrel A Regier
Uniformed Services University of the Health Sciences | USUHS · Department of Psychiatry--Center for the Study of Traumatic Stress

M.D., M.P.H.

About

239
Publications
126,256
Reads
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45,727
Citations
Additional affiliations
May 2014 - January 2016
Uniformed Services University of the Health Sciences
Position
  • Senior Scientist, Adjunct Professor in Psychiatry

Publications

Publications (239)
Article
The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research...
Article
Objective: Posttraumatic stress disorder (PTSD) is prevalent and sometimes severely disabling. Providing effective treatment for PTSD and addressing its social consequences require accurate diagnosis. PTSD criteria have changed in all editions of the American Diagnostic Criteria since introduction of the diagnosis in DSM-III in 1980. The DSM-5 Fiel...
Article
Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is ge...
Chapter
The fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the eleventh edition of the World Health Organization’s International Classification of Diseases (ICD-11) chapter on mental and behavioural disorders represent interrelated milestones in the understanding of psychiatric (men...
Article
Objective: Diagnosis is a cornerstone of clinical practice for mental health care providers, yet traditional diagnostic systems have well-known shortcomings, including inadequate reliability, high comorbidity, and marked within-diagnosis heterogeneity. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a data-driven, hierarchically based alte...
Article
The initial plans for the DSM-5 revision envisioned a paradigm shift away from traditional diagnostic categories. However, plans for a major move from descriptive to etiologic diagnoses were quickly abandoned as infeasible. Support was much broader for adding dimensional/spectrum constructs to the categorical diagnoses, although this was interprete...
Article
Full-text available
Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is ge...
Article
Full-text available
The reliability and validity of traditional taxonomies are limited by arbitrary boundaries between psychopathology and normality, often unclear boundaries between disorders, frequent disorder co-occurrence, heterogeneity within disorders, and diagnostic instability. These taxonomies went beyond evidence available on the structure of psychopathology...
Article
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) contains criteria for psychiatric diagnoses that reflect advances in the science and conceptualization of mental disorders and address the needs of clinicians. DSM-5 also recommends research on dimensional measures of cross-cutting symptoms and diagnostic severity, whi...
Article
Full-text available
The primary purpose of this article is to review the career outcomes of a research training program specifically targeted to young psychiatric researchers from minority populations underrepresented in psychiatry. The aims of the program were (1) to support psychiatric investigators from under-represented populations in the development and maintenan...
Article
Abstract The Practice Research Network (PRN) was established in 1993 to bridge the gap between the science base and the clinical practice of psychiatry by expanding the generalizability of findings and involving clinicians in the development and conduct of research. It began as a nationwide network of psychiatrists and has evolved to conduct large-...
Article
Full-text available
Objective: This article describes the clinical utility and feasibility of proposed DSM-5 criteria and measures as tested in the DSM-5 Field Trials in Routine Clinical Practice Settings (RCP). METHODS RCP data were collected online for six months (October 2011 to March 2012). Participants included psychiatrists, licensed clinical psychologists, cli...
Article
Objective: This report describes the sustainability of quality improvement interventions for depression care in psychiatric practice one year after the completion of the National Depression Management Leadership Initiative (NDMLI) in 2006. The main intervention involved continued use of the nine-item depression scale of the Patient Health Question...
Article
Full-text available
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) marks the first significant revision of the publication since the DSM-IV in 1994. Changes to the DSM were largely informed by advancements in neuroscience, clinical and public health need, and identified problems with the classification system and criteria put forth in...
Article
Readers will recognize a few notable differences from DSM-IV. One distinction is DSM-5 's emphasis on numerous issues important to diagnosis and clinical care, including the influence of development, gender, and culture on the presentation of disorders.² This is present in select diagnostic criteria, in text, or in both, which include variations of...
Article
Full-text available
Objective: The DSM-5 Field Trials were designed to obtain precise (standard error,0.1) estimates of the intraclass kappa asa measure of the degree to which two clinicians could independently agree on the presence or absence of selected DSM-5 diagnoses when the same patient was interviewed on separate occasions, in clinical settings, and evaluated...
Article
Full-text available
Objective: The authors sought to document, in adult and pediatric patient populations, the development, descriptive statistics,and test-retest reliability of cross-cutting symptom measures proposed for inclusion in DSM-5. Method: Data were collected as part of the multisite DSM-5 Field Trials in large academic settings. There were seven sites fo...
Article
Full-text available
Objective: This article discusses the design,sampling strategy, implementation,and data analytic processes of the DSM-5 Field Trials. Method: The DSM-5 Field Trials were conducted by using a test-retest reliability design with a stratified sampling approach across six adult and four pediatric sites in the United States and one adult site in Cana...
Article
Revisions to the Diagnostic and Statistical Manual of Mental Disorders aim to ground diagnoses in empirical evidence, make them less stigmatizing, and incorporate assessments of patients' functioning over time.
Article
This study determined rates of response and remission at 12 and 24 weeks among patients being treated by psychiatrists for depression on the basis of Patient Health Questionnaire-9 (PHQ-9) scores and identified factors associated with response and remission. Adult patients at 17 psychiatric practices participating in the National Depression Managem...
Article
More than 10 years prior to the anticipated 2013 publication of DSM-5, processes were set in motion to assess the research and clinical issues that would best inform future diagnostic classification of mental disorders. These efforts intended to identify the clinical and research needs within various populations, examine the current state of the sc...
Article
To examine correlates of mental health treatment seeking such as gender, diagnosis, impairment, distress and mastery. Longitudinal epidemiological data from the Zurich Study of common psychiatric syndromes, including unipolar and bipolar depression, panic, anxiety, neurasthenia and insomnia, were utilized. In longitudinal Generalized Estimating Equ...
Article
Beginning January 1, 2006, the Medicare Part D prescription drug benefit shifted drug coverage from Medicaid to the new Medicare Part D program for patients who were eligible for both Medicare and Medicaid benefits ("dual-eligibles"). These patients were randomly assigned to a private Part D plan and came under specific formulary and utilization ma...
Conference Paper
Objective: Examine risk and identified potential gaps in continuity of care for homelessness and incarceration among psychiatric patients in ten states. Method: 4,866 psychiatrists in ten states were randomly selected from the AMA Physician Masterfile; 61% responded; 34% met study eligibility criteria and reported clinically detailed data on 1,625...
Conference Paper
Objective: Assess the relationship between medication access and continuity problems and suicidal ideation or behavior among psychiatric patients with Medicare and Medicaid insurance during the first year of the Part D benefit. Methods: Psychiatrists were randomly selected from the AMA Masterfile. After excluding those not practicing and with undel...
Article
To quantify the extent to which Medicaid programs may incur increased psychiatric emergency department and hospital use associated with clinically unintended medication discontinuations, gaps, switches and other access problems attributed to prescription drug coverage and management. This study uses clinically detailed, physician-reported data. A t...
Article
Full-text available
The purpose of successive DSM revisions is to incorporate the growing knowledge base about mental disorders into diagnosis and to bring diagnostic criteria ever closer to accurate and precise identification of corresponding disorders (5). However, this goal must be accomplished while maintaining the clinical utility of the diagnostic criteria for p...
Article
The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is scheduled for publication in 2013. Although psychiatrists and other mental health care professionals have a high level of interest in this forthcoming edition, other health care professionals should also be interested in the development of DSM-5. For instance, in...
Article
This study provides national data on medication access and continuity problems experienced during the first year of the Medicare Part D prescription drug program, which was implemented on January 1, 2006, among a national sample of Medicare and Medicaid "dual eligible" psychiatric patients. Practice-based research methods were used to collect clini...
Article
Full-text available
This study examined the occurrence of medication access problems and use of intensive mental health services after the transition in January 2006 from Medicaid drug coverage to Medicare Part D for persons dually eligible for Medicaid and Medicare benefits. Psychiatrists randomly selected from the American Medical Association's Physicians Masterfile...
Article
The American Psychiatric Association, in collaboration with the World Health Organization and the National Institutes of Health, has undertaken a 5-year international research planning effort in preparation for the formal revision of the Diagnostic and Statistical Manual of Mental Disorders. One element of the project was a conference titled "Obses...
Article
Full-text available
The aims of this study were to compare medication access problems among psychiatric patients in ten state Medicaid programs, assess adverse events associated with medication access problems, and determine whether prescription drug utilization management is associated with access problems and adverse events. Psychiatrists from the American Medical A...
Article
The gap between evidence-based treatments and routine care has been well established. Findings from the Sequenced Treatments Alternatives to Relieve Depression (STAR*D) emphasized the importance of measurement-based care for the treatment of depression as a key ingredient for achieving response and remission; yet measurement-based care approaches a...
Article
Development of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) has been ongoing since 1994, though official release will not occur for another 4 years. Potential revisions are being derived from multiple sources, including building on perceived limitations of DSM-IV; broad-based literature reviews; secondary a...
Article
To describe factors associated with initiation of depot antipsychotic medications in psychiatric outpatients with schizophrenia and recent medication nonadherence. A national sample of psychiatrists reported on adult outpatients with schizophrenia who were nonadherent with oral antipsychotic medications in the last year. In total, 17.6% of psychiat...
Article
We compare psychiatric management of antipsychotic non-adherence among schizophrenia outpatients with high and low levels of family contact. A national survey was conducted among a random sample of psychiatrists treating schizophrenia, providing data on 310 patients. Patients were stratified by level of family contact. Psychiatrists were more likel...
Article
The Developmental Process for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition - Volume 13 Issue 2 - Darrel A. Regier
Article
With implementation of Medicare Part D, concerns were raised that patients with severe mental illness who were dually eligible for both Medicaid and Medicare benefits would be at clinical risk. In addition to concerns about medication access and continuity, there were concerns about administrative burden for physicians and their staffs. This study...
Article
Objective: With implementation of Medicare Part D, concerns were raised that patients with severe mental illness who were dually eligible for both Medicaid and Medicare benefits would be at clinical risk. In addition to concerns about medication access and continuity, there were concerns about administrative burden for physicians and their staffs....
Article
Two current congressional bills mandate parity for benefits for mental disorders with benefits for medical/surgical conditions in private insurance when mental health benefits are provided; the bills differ in regard to benefit levels and access to out-of-network coverage. This study assessed clinicians' and beneficiaries' participation in managed...
Article
It is remarkable that the phenotype of psychosis that is standard throughout the world today originated in mid-19th century psychiatric hospitals with the formulations of Kraepelin. Now, more than 100 years later, this issue of Schizophrenia Bulletin presents a selection of papers reporting the proceedings of a conference titled “Deconstructing Psy...
Article
Full-text available
Despite numerous clinical trials, it is unknown whether ethnicity affects treatment response to cognitive enhancers in Alzheimer's disease (AD). There is convincing evidence of ethnic and genetic variability in drug metabolism. This article reviews the available data on ethnicity in clinical trials for AD to answer two questions: (1) what are the c...
Article
Full-text available
The American Psychiatric Association (APA) will publish the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), in 2012. This paper reviews the extended, multi-faceted research planning preparations that APA has undertaken, several in collaboration with the World Health Organization and the U.S. National Institutes of Heal...
Article
Full-text available
This study attempted to systematically assess the experiences of Medicare and Medicaid "dual-eligible" psychiatric patients, including evaluating patients' access to medications and the administrative functioning of the program, during the first 4 months of the Medicare Part D prescription drug benefit. Psychiatrists (N=5,833) were randomly selecte...
Article
Obsessive-Compulsive Behavior Spectrum: Refining the Research Agenda for the DSM-V - Volume 12 Issue 5 - Darrel A. Regier
Article
Douglas M. Ziedonis co-authored this practice guideline as a member of the Work Group on Substance Abuse Disorders. See article for complete list of authors.
Article
Full-text available
This report summarizes recommendations from the ACNP Task Force on the conceptualization of remission and its implications for defining recovery, relapse, recurrence, and response for clinical investigators and practicing clinicians. Given the strong implications of remission for better function and a better prognosis, remission is a valid, clinica...
Article
To compare the clinical characteristics and psychiatric management of antipsychotic nonadherence among outpatients with schizophrenia who either do or do not have current or past comorbid substance use disorders, a national survey was conducted of psychiatrists engaged in the management of schizophrenia. Respondents reported on the presentation and...
Article
The purpose of this study is to present data on the rates of diagnosis and patterns of Axis I comorbidity treated by psychiatrists in routine psychiatric practice, ascertained by practicing psychiatrists, and compare them with those ascertained through structured interview in a national sample of individuals treated in the specialty mental health s...
Article
Psychotherapy has long been recognized as a key component of psychiatric care. However, concerns have been raised about access to psychotherapy as a result of changes in the financing and management of care. This study examined patterns and predictors of receipt of psychotherapy among patients of psychiatrists. Data were collected for 587 psychiatr...