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.

Pediatric anxiety disorders: from neuroscience to evidence-based clinical practice

“…15,43 Etiology and pathophysiology Mental disorders reflect individual differences in brain function. 31,44,45 Those differences are a result of a complex combination of factors that ultimately represent the distal effects of risk genes and/or environmental components (etiological factors). These etiological risk factors act on neural circuits (neural substrates) during brain development and cause quantitative and/or qualitative abnormalities in brain functions (pathophysiological processes).…”

Child and adolescent psychiatry as a clinical neuroscience

“…Special proteins may help to identify such processes in the brain-the field of proteo-and metabolomics. A. Warnke was the first to support this kind of research in German child and adolescent psychiatry, which in future might lead to early detection and probably prevention of major mental disorders (Insel and Quirion 2005). His co-workers in Wurzburg further engage in neuroimaging and neurophysiology, which are major research areas represented in this journal.…”

Should psychiatry become Social Neuroscience?

“…Psychiatry has currently been warned either to become a 'clinical neuroscience' abandoning descriptive psychopathology (3,12) or to adopt a psychosocial paradigm, conceptualising mental disorders in terms of understandable responses to adverse environmental situations or problematic interpersonal relationships (3). Social Neuroscience is not only concerned with biological mechanismsusing neuroscience methodology -it is also helpful in elucidating the perception and understanding of others' mental states and the development and maintenance of social bonds are under study (13,14).…”