The Impact of Translational Neuroscience on Revisiting Psychiatric Diagnosis: State of the Art and Conceptual Analysis

Abstract

This paper reviews translational research in psychiatry, focusing on those programs addressing the problem of the validity of psychiatric diagnoses. In medicine in general, and in psychiatry in particular, the term “translational” is used with different meanings. A conceptual analysis suggests that there are at least seven different types of translational research in psychiatry: T1 (“bench-to-bedside” development of tools and treatments), T2 (application of animal models to human psychiatry), T3 (papers focusing on the mind-brain gap, studying biological, neurobiological and cognitive dysfunctions), T4 (personalised therapies and prediction of treatment responses), T5 (“bedside-to-bench” translation of population data for laboratories), T6 (implementation of treatments at the population level, including accessibility and quality of services), and T7 (improving translational knowledge in residents’ trainings and researchers’ careers).Concerning the problem of validity of psychiatric diagnoses, new neurocognitive models like the Research Domain Criteria project are considered, in particular the translational program of cross-validation aimed at reducing the gap between neuroimaging data and psychopathological scores derived from rating-scales. It is shown that these programs are useful, filling some of the current research gaps, but it is also stressed that they carry implicit realist and reductionist assumptions. It is finally suggested that the formation of mental symptoms is a complex process involving both neurocognitive and semantic factors, which raises doubts about the possibility of complete translations, without residuals.

Objective quantification of psychomotor disturbances in patients with a major depressive episode

“…As a clinical syndrome, depression remains puzzling and paradoxical probably because of the affective and motor dysregulation in different brain structures and the complex interactions between these structures. Despite the rapid development of neuroscience and genetics, there are still unresolved issues regarding the nature, classification, and aetiology of depression and psychiatric disorders in general . Therefore, a revision of the present diagnostic standards, taxonomies, and treatment guidelines is needed and may be achieved by more in‐depth studies aimed at understanding the underlying mechanisms of these mental disorders.…”

Objective and quantitative equilibriometric evaluation of individual locomotor behaviour in schizophrenia: Translational and clinical implications

“…Thus, the discovered locomotor abnormalities in schizophrenic patients might be conceived as translational human equivalents of the animal locomotor models aimed at objectively investigating the brain mechanisms of schizophrenia and its pharmacological treatment. In a recent review focused on the translational research in psychiatry, at least 7 types of translation (T‐types) were identified . Our data might be associated with at least 4 of them: (T1) practical application of neuroscience knowledge in clinical psychiatry (practice‐based research or developments of tools and treatments that could be used clinically or commercialized); (T2) application of animal models to human psychiatry; (T3) research methods to fill the gap between “objective” neuroscientific data and “subjective” mental phenomena; and (T4) personalized therapies and prediction of treatment response.…”

Somatoform disorder in primary care: The influence of co‐morbidity with anxiety and depression on health care utilization

“…Within the translational approach of this special issue, besides psychological and social mechanisms, neuropsychological mechanisms such as findings from psychoneuroimmunology and mechanisms of somatic and psychological symptom perception might be relevant for co‐morbidity and its consequences . Due to the general lack of neuropsychological evidence within the field of somatoform disorders, empirical evidence from other fields might in turn provide valuable starting points for hypothesis‐based research in the future . The role of co‐morbidity, for example, has not been investigated in the context mentioned above.…”

“…33 Due to the general lack of neuropsychological evidence within the field of somatoform disorders, 34 empirical evidence from other fields might in turn provide valuable starting points for hypothesis-based research in the future. 35 The role of co-morbidity, for example, has not been investigated in the context mentioned above.…”