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Precision and personalized assessment, diagnosis and treatment in psychiatry

Published online by Cambridge University Press:  31 March 2020

Konstantinos N. Fountoulakis Open the ORCID record for Konstantinos N. Fountoulakis [Opens in a new window]  and
Stephen M. Stahl
Konstantinos N. Fountoulakis*
Affiliation:
Third Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
Stephen M. Stahl
Affiliation:
Department of Psychiatry, University of California, San Diego, California, USA Department of Psychiatry, Cambridge University, Cambridge, United Kingdom
*
*Konstantinos N. Fountoulakis, MD, Email: kfount@med.auth.gr
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Abstract

“Precision medicine” and “personalized medicine” constitute goals of research since antiquity and this was intensified with the arrival of the “evidence-based medicine.” precision and personalized psychiatry (3P) when achieved will constitute a radical shift in our paradigm and it will be even more transformative than in other fields of medicine. The biggest problems so far are the problematic definition of mental disorder, available treatments seem to concern broad categories rather than specific disorders and finally clinical predictors of treatment response or side effects and biological markers do not exist. Precision and personalized psychiatry like all precision medicine will be a laborious and costly task; thus the partnership of scientists with industry and the commercialization of new methods and technologies will be an important element for success. The development of an appropriate legal framework which will both support development and progress but also will protect the rights and the privacy of patients and their families is essential.

Keywords

Precision psychiatrypersonalized psychiatryevidence based psychiatry
Type
Perspective
Information
CNS Spectrums , Volume 26 , Issue 4 , August 2021 , pp. 326 - 332
Copyright
© The Author(s) 2020. Published by Cambridge University Press

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References

Dance, A. Medical histories. Nature. 2016;537(7619):S52–S53.CrossRefGoogle ScholarPubMed
Hamburg, MA, Collins, FS. The path to personalized medicine. N Engl J Med. 2010;363(4):301–304.CrossRefGoogle ScholarPubMed
Chambers, DA, Feero, WG, Khoury, MJ. Convergence of implementation science, precision medicine, and the learning health care system: a new model for biomedical research. JAMA. 2016;315(18):1941–1942.CrossRefGoogle ScholarPubMed
Perlman, RL, Govindaraju, DR, Archibald, E. Garrod: the father of precision medicine. Genet Med. 2016;18(11):1088–1089.CrossRefGoogle ScholarPubMed
Dudley, J, Karczewski, K. Exploring Personal Genomics. Oxford, UK: Oxford University Press; 2014.Google Scholar
Mancinelli, L, Cronin, M, Sadee, W. Pharmacogenomics: the promise of personalized medicine. AAPS PharmSci. 2000;2(1):E4.CrossRefGoogle ScholarPubMed
Biomarkers Definitions Working Group. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther. 2001;69(3):89–95.CrossRefGoogle Scholar
Bird, A. Perceptions of epigenetics. Nature. 2007;447(7143):396–398.CrossRefGoogle ScholarPubMed
Kelkar, SS, Reineke, TM. Theranostics: combining imaging and therapy. Bioconjug Chem. 2011;22(10):1879–1903.CrossRefGoogle ScholarPubMed
Mesko, B. The role of artificial intelligence in precision medicine. Expert Rev Precis Med Drug Dev. 2017;2(5):239–241.CrossRefGoogle Scholar
Yahata, N, Kasai, K, Kawato, M. Computational neuroscience approach to biomarkers and treatments for mental disorders. Psychiatry Clin Neurosci. 2017;71(4):215–237.CrossRefGoogle ScholarPubMed
Kuhn, T. The Structure of Scientific Revolutions. 4th ed.. Chicago, IL: The University of Chicago Press; 1962.Google Scholar
The Precision Medicine Initiative; 2015. https://obamawhitehouse.archives.gov/node/333101. Accessed June 10, 2018.Google Scholar
Ashley, EA. The precision medicine initiative: a new national effort. JAMA. 2015;313(21):2119–2120.CrossRefGoogle ScholarPubMed
Terry, SF. Obama’s precision medicine initiative. Genet Test Mol Biomarkers. 2015;19(3):113–114.CrossRefGoogle ScholarPubMed
Collins, FS, Varmus, H. A new initiative on precision medicine. N Engl J Med. 2015;372(9):793–795.CrossRefGoogle ScholarPubMed
Cunningham, P. The Health 202: NIH wants 1 million Americans to contribute to new pool of gene data. Washington Post. January 16, 2018.Google Scholar
Cutler, DM, Rosen, AB, Vijan, S. The value of medical spending in the United States, 1960–2000. N Engl J Med. 2006;355(9):920–927.CrossRefGoogle ScholarPubMed
National Research Council Committee on a Framework for Developing a New Taxonomy of Disease. Toward Precision Medicine. Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease. Washington, DC: National Academies Press; 2011.Google Scholar
U.S. FDA. Paving the Way for Personalized Medicine: FDA’s Role in a New Era of Medical Product Development. Silver Spring, MD: U.S. Food and Drug Administration; 2013.Google Scholar
Roesler, J, Tyler, L, Canady, K, Zhong, L. Intellectual Property Issues Impacting the Future of Personalized Medicine. AIPLA’s MidWinter Institute for CLE Credits; 2013. Tampa, Florida.Google Scholar
Fisher, ES, Shortell, SM, Savitz, LA. Implementation science: a potential catalyst for delivery system reform. JAMA. 2016;315(4):339–340.CrossRefGoogle ScholarPubMed
Collins, PY, Patel, V, Joestl, SS, et al. Grand challenges in global mental health. Nature. 2011;475(7354):27–30.CrossRefGoogle ScholarPubMed
Benyamina, A, Blecha, L, Reynaud, M. Global burden of disease in young people aged 10–24 years. Lancet. 2012;379(9810):29.CrossRefGoogle ScholarPubMed
Insel, TR. The NIMH Research Domain Criteria (RDoC) Project: precision medicine for psychiatry. Am J Psychiatry. 2014;171(4):395–397.CrossRefGoogle ScholarPubMed
Alda, M. Personalized psychiatry: many questions, fewer answers. J Psychiatry Neurosci. 2013;38(6):363–365.CrossRefGoogle ScholarPubMed
Friston, KJ. Precision psychiatry. Biol Psychiatry Cogn Neurosci Neuroimag. 2017;2(8):640–643.Google ScholarPubMed
Kendler, KS. The nature of psychiatric disorders. World Psychiatry. 2016;15(1):5–12.CrossRefGoogle ScholarPubMed
Andersson, G, Titov, N. Advantages and limitations of Internet-based interventions for common mental disorders. World Psychiatry. 2014;13(1):4–11.CrossRefGoogle ScholarPubMed
Arranz, MJ, de Leon, J. Pharmacogenetics and pharmacogenomics of schizophrenia: a review of last decade of research. Mol Psychiatry. 2007;12(8):707–747.CrossRefGoogle ScholarPubMed
Barnett, JH, Smoller, JW. The genetics of bipolar disorder. Neuroscience. 2009;164(1):331–343.CrossRefGoogle ScholarPubMed
Fernandes, BS, Williams, LM, Steiner, J, Leboyer, M, Carvalho, AF, Berk, M. The new field of ‘precision psychiatry’. BMC Med. 2017;15(1):80.CrossRefGoogle ScholarPubMed
International Schizophrenia, C, Purcell, SM, Wray, NR, et al. Common polygenic variation contributes to risk of schizophrenia and bipolar disorder. Nature. 2009;460(7256):748–752.CrossRefGoogle Scholar
Allen, NC, Bagade, S, McQueen, MB, et al. Systematic meta-analyses and field synopsis of genetic association studies in schizophrenia: the SzGene database. Nat Genet. 2008;40(7):827–834.CrossRefGoogle ScholarPubMed
Kraemer, HC, Schultz, SK, Arndt, S. Biomarkers in psychiatry: methodological issues. Am J Geriatr Psychiatry. 2002;10(6):653–659.CrossRefGoogle ScholarPubMed
Binder, EB, Nemeroff, CB. Implications for the practice of psychiatry. In: Hemby, SE, Bahn, S, eds. Progress in Brain Research. Vol 158. Elsevier; 2006:275–293.Google Scholar
Bogdan, R, Hyde, LW, Hariri, AR. A neurogenetics approach to understanding individual differences in brain, behavior, and risk for psychopathology. Mol Psychiatry. 2013;18(3):288–299.CrossRefGoogle ScholarPubMed
Corlett, PR, Fletcher, PC. Computational psychiatry: a Rosetta Stone linking the brain to mental illness. Lancet Psychiatry. 2014;1(5):399–402.CrossRefGoogle ScholarPubMed
Gillespie, CF, Binder, EB, Holtzheimer, PE, Nemeroff, CB. Stress and the impact of personalized medicine. In: Integrative Neuroscience and Personalized Medicine. Oxford University Press; 2010;73–92.CrossRefGoogle Scholar
de Leon, J. Pharmacogenomics: the promise of personalized medicine for CNS disorders. Neuropsychopharmacology. 2009;34(1):159–172.CrossRefGoogle ScholarPubMed