Rethinking psychiatry with OMICS science in the age of personalized P5 medicine: ready for psychiatome?

Philosophy, Ethics, and Humanities in Medicine

Nicola Luigi Bragazzi¹ 

[1] Department of Health Sciences (DISSAL), School of Public Health, University of Genoa, Via Pastore 1, 16132, Genoa, Italy

关键词: OMICS;    DSM-V;    Personalized medicine;    New psychiatry;    Bioinformatics;    Network medicine;    Systems biology;    Biological psychiatry;   

Others  :  816439
DOI  :  10.1186/1747-5341-8-4

 received in 2012-05-02, accepted in 2013-06-20,  发布年份 2013

【 摘 要 】

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is universally acknowledged as the prominent reference textbook for the diagnosis and assessment of psychiatric diseases. However, since the publication of its first version in 1952, controversies have been raised concerning its reliability and validity and the need for other novel clinical tools has emerged. Currently the DSM is in its fourth edition and a new fifth edition is expected for release in 2013, in an intense intellectual debate and in a call for new proposals.

Since 1952, psychiatry has undergone many changes and is emerging as unique field in the medical area in which a novel approach is being demanded for properly treating patients: not the classical “one-size-fits-all” approach, but a more targeted and tailored diagnosis and therapeutics, taking into account the complex interactions among genes and their products, environment, culture and the psychological apparatus of the subject.

OMICS sciences, being based on high-throughput technologies, are systems biology related fields (like genomics, proteomics, transcriptomics and so on). In the frame of the P5 medicine (personalized, participatory, predictive, preventive, psycho-cognitive), they could establish links between psychiatric diseases, which are disorders with a final common symptomatology with vastly heterogeneous biological, environmental and sociological underpinnings, and by understanding the psychiatric diseases beyond their classic symptomatic or syndromal definitions using OMICS research, one can have a broader picture and unprecedented links and reclassification of psychiatric nosology. Importantly, by understanding the basis of heterogeneity in diseases through OMICS research, one could also personalize treatment of psychiatric illnesses.

In this manuscript, we discuss a gap in the current psychiatric research, namely the missing logical link among OMICS, personalized medicine and reclassification of diseases. Moreover, we explore the importance of incorporating OMICS-based quantitative dimensional criteria, besides the classical qualitative and categorical approach.

【 授权许可】

   
2013 Bragazzi; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Patil T, Giordano J: On the ontological assumptions of the medical model of psychiatry: philosophical considerations and pragmatic tasks. Philos Ethics Humanit Med 2010, 5:3. BioMed Central Full Text
• [2]Kawa S, Giordano J: A brief historicity of the Diagnostic and Statistical Manual of Mental Disorders: issues and implications for the future of psychiatric canon and practice. Philos Ethics Humanit Med 2012, 7:2. BioMed Central Full Text
• [3]Gorini A, Pravettoni G: P5 medicine: a plus for a personalized approach to oncology. Nat Rev Clin Oncol 2011, 8(7):444.
• [4]Pravettoni G, Gorini A: P5 cancer medicine approach: why personalized medicine cannot ignore psychology. J Eval Clin Pract 2011, 17:594-6.
• [5]Ozdemir V, Knoppers BM: One size does not fit all: toward "upstream ethics"? Am J Bioeth 2010, 10(6):42-4.
• [6]Hood L, Friend SH: Predictive, personalized, preventive, participatory (P4) cancer medicine. Nat Rev Clin Oncol March, 8:184-187.
• [7]Broich K, Möller HJ: Pharmacogenetics, pharmacogenomics and personalized psychiatry: are we there yet? Eur Arch Psychiatry Clin Neurosci 2008, 258(Suppl. 1):1-2.
• [8]Möller HJ, Rujescu D: Pharmacogenetics – genomics and personalized psychiatry. Eur Psychiatry 2010, 25:291-293.
• [9]De Leon J: The future (or lack of future) of personalized prescription in psychiatry. Pharmacol Res 2009, 59(2):81-89.
• [10]Gurwitz D, Weizman A: Personalized psychiatry: a realistic goal. Pharmacogenomics 2004, 5(2):213-7.
• [11]Ozdemir V, Basile V, Masellis M, Muglia P, Kennedy JL: Pharmacogenomics and personalized therapeutics in psychiatry. In Neuropsychopharmacology: The fifth generation of progress American College of Neuropsychopharmacology. Edited by Davis KL, Charney D, Coyle JT, Nemeroff C. New York: Lippincott Williams & Wilkins; 2002:495-506.
• [12]Filakovi P, Petek A: Personalized pharmacotherapy in psychiatry. Psychiatr Danub 2009, 21(3):341-346.
• [13]Műller-Spahn F: Individualized preventive psychiatry: syndrome and vulnerability diagnostics. Eur Arch Psychiatry Clin Neurosci 2008, 258(suppl 5):92-97.
• [14]De Leon J: AmpliChip CYP450 test: personalized medicine has arrived in psychiatry. Expert Rev Mol Diagn 2006, 6:277-286.
• [15]Stahl SM: Personalized medicine, pharmacogenomics, and the practice of psychiatry: on the threshold of predictive therapeutics in psychopharmacology? CNS Spectrum 2008, 13:115-118.
• [16]Jain KK: Personalized medicine. Curr Opin Mol Ther 2002, 4:548-558.
• [17]Ozdemir V, Fisher E, Dove ES, Burton H, Wright GE, Masellis M, Warnich L: End of the beginning and public health pharmacogenomics: knowledge in 'Mode 2' and P5 medicine. Curr Pharmacogenomics Person Med 2012, 10(1):1-6.
• [18]Kendler KS, Muñoz RA, Murphy G: The development of the Feighner criteria: a historical perspective. Am J Psychiatry 2009, 167:134-142.
• [19]Wallerstein RS: The Psychodynamic Diagnostic Manual (PDM): rationale, conception, and structure. J Am Psychoanal Assoc 2011, 59(1):153-64.
• [20]Engel GL: The need for a new medical model: a challenge for biomedicine. Science 1977, 196(4286):129-36.
• [21]Ghaemi N: The concepts of psychiatry: A pluralistic approach to the mind and mental illness. Baltimore: Johns Hopkins University Press; 2003.
• [22]Eid M: The Bio-Psycho-Social model: how accurate and valid is it? J Psychol Psychother. 2012, 2:e103.
• [23]Del Puente G, Bragazzi NL: The Bio-psycho-social model and beyond: its limitations and the need for a new model. A response to Eid's Editorial, “The Bio-Psycho-Social model: how accurate and valid is it? Open Access Scientific Reports. 2012, 1:399.
• [24]Andrews G, Goldberg DP, Krueger RF, Carpenter WT, Hyman SE, Sachdev P, Pine DS: Exploring the feasibility of a meta-structure for DSM-V and ICD-11: could it improve utility and validity? Psychol Med 2009, 39(12):1993-2000.
• [25]Gottesman II, Gould TD: The endophenotype concept in psychiatry: etymology and strategic intentions. Am J Psychiatry 2003, 160(4):636-45.
• [26]Giordano J: Neuroimaging in psychiatry: approaching the puzzle as a piece of the bigger picture(s). AJOB-Neuroscience 2012, 3(4):54-56.
• [27]Giordano J, Engebretson J, Benedikter R: Pain and culture: considerations for meaning and context. Cambridge Quarterly Rev. Healthcare Ethics. 2008, 77:45-59.
• [28]Giordano J, Wurzman R: Neurological disease and depression: the possibility and plausibility of putative neuropsychiatric spectrum disorders. Depression: Mind and Body 2008, 4(1):2-5.
• [29]Ozdemir V, Suarez-Kurtz G, Stenne R, Somogyi AA, Someya T, Kayaalp SO, Kolker E: Risk assessment and communication tools for genotype associations with multifactorial phenotypes: the concept of "edge effect" and cultivating an ethical bridge between omics innovations and society. OMICS 2009, 13(1):43-61.
• [30]Goh KI, Cusick ME, Valle D, Childs B, Vidal M, Barabási AL: The human disease network (the human diseasome). Proc Natl Acad Sci USA 2007, 104:8685-8690.
• [31]Alam S, Patel J, Giordano J: Working towards a new psychiatry - neuroscience, technology and the DSM-5. Philos Ethics Humanit Med 2012, 7:1. BioMed Central Full Text
• [32]Giordano J, Engebretson JC: Don't ignore religious beliefs. Tex Med 2005, 101(2):7-8.
• [33]Richerson PJ, Boyd R, Henrich J: Gene-culture coevolution in the age of genomics. Proc Natl Acad Sci U S A 2010, 107(Suppl 2):8985-92.
• [34]Wurzman R, Giordano J: Differential susceptibility to plasticity: a 'missing link' between gene culture co-evolution and neuropsychiatric spectrum disorders? BMC Med 2012, 10:37. BioMed Central Full Text
• [35]Belsky J, Jonassaint C, Pluess M, Stanton M, Brummett B, Williams R: Vulnerability genes or plasticity genes? Mol Psychiatry 2009, 14:746-754.
• [36]Caspi A, Moffitt TE: Gene-environment interactions in psychiatry: Joining forces with neuroscience? Nat Rev Neurosci 2006, 7:583-590.
• [37]Costae Silva JA: Personalized medicine in psychiatry: new technologies and approaches. Metabolism 2013, 62:1-40.
• [38]Turck CW, Maccarrone G, Sayan-Ayata E, Jacob AM, Ditzen C, Kronsbein H, Birg I, Doertbudak CC, Haegler K, Lebar M, Teplytska L, Kolb N, Uwaje N, Zollinger R: The quest for brain disorder biomarkers. J Med Invest 2005, 52 Suppl:231-5.
• [39]Bragazzi NL, Sivozhelezov V, Nicolini C: Leader gene: a fast data-mining tool for molecular genomics. J Proteomics Bioinform 2011, 4(4):083-086.
• [40]Racapé M, Bragazzi N, Sivozhelezov V, Danger R, Pechkova E, Nicolini C, Brouard S, Soulillou JP, Duong Van Huyen JP: SMILE silencing and PMA activation gene networks in HeLa cells: comparison with kidney transplantation gene networks. J Cell Biochem 2012, 113(6):1820-32.
• [41]Orlando B, Bragazzi N, Nicolini C: Bioinformatics and systems biology analysis of genes network involved in OLP (Oral Lichen Planus) pathogenesis. Arch Oral Biol 2013, 58(6):664-73.
• [42]Nicolini C, Bragazzi N, Pechkova E: Nanoproteomics enabling personalized nanomedicine. Adv Drug Deliv Rev 2012, 64(13):1522-31.
• [43]Nicolini C, Bruzzese D, Cambria MT, Bragazzi NL, Pechkova E: Recombinant laccase: I Enzyme cloning and characterization. J Cell Biochem 2013, 114(3):599-605.
• [44]Bragazzi NL, Pechkova E, Scudieri D, Terencio TB, Adami M, Nicolini C: Recombinant laccase: II. Medical biosensor. Crit Rev Eukaryot Gene Expr 2012, 22(3):197-203.
• [45]Nicolini C, Adami M, Sartore M, Bragazzi NL, Bavastrello V, Spera R, Pechkova E: Prototypes of newly conceived inorganic and biological sensors for health and environmental applications. Sensors (Basel) 2012, 12(12):17112-27.
• [46]Bragazzi NL, Del Puente G: Panic attacks and possession by djinns: lessons from ethnopsychiatry. Psychol Res Behav Manag 2012, 5:185-90.