Psychiatry as a Clinical Neuroscience Discipline

Abstract

One of the fundamental insights emerging from contemporary neuroscience is that mental illnesses are brain disorders. In contrast to classic neurological illnesses that involve discrete brain lesions, mental disorders need to be addressed as disorders of distributed brain systems with symptoms forged by developmental and social experiences. While genomics will be important for revealing risk, and cellular neuroscience should provide targets for novel treatments for these disorders, it is most likely that the tools of systems neuroscience will yield the biomarkers needed to revolutionize psychiatric diagnosis and treatment. This essay considers the discoveries that will be necessary over the next two decades to translate the promise of modern neuroscience into strategies for prevention and cures of mental disorders. To deliver on this spectacular new potential, clinical neuroscience must be integrated into the discipline of psychiatry, thereby transforming current psychiatric training, tools, and practices.Genomics and neuroscience represent two areas of science fundamental to understanding the brain, and thus, fundamental to psychiatry. By any measure, they have undergone revolutionary changes in the past twenty years. Yet methods of diagnosis and treatment for patients with mental disorders have remained relatively unchanged. Meanwhile, during this period the public health burden of mental disorders has grown alarmingly. Mental disorders are now among the largest sources of medical disability not only in North America but worldwide 1 and, like AIDS and cancer, they are problems that are both urgent and deadly.

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