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

Bragazzi NL - Philos Ethics Humanit Med (2013)

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Health Sciences, School of Public Health, University of Genoa, Italy. nicola@genethics.ethicsoft.it

ABSTRACT

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is universallyacknowledged as the prominent reference textbook for the diagnosis and assessmentof psychiatric diseases. However, since the publication of its first version in1952, controversies have been raised concerning its reliability and validity andthe need for other novel clinical tools has emerged. Currently the DSM is in itsfourth edition and a new fifth edition is expected for release in 2013, in anintense intellectual debate and in a call for new proposals.

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

OMICS sciences, being based on high-throughput technologies, are systems biologyrelated fields (like genomics, proteomics, transcriptomics and so on). In theframe of the P5 medicine (personalized, participatory, predictive, preventive,psycho-cognitive), they could establish links between psychiatric diseases, whichare disorders with a final common symptomatology with vastly heterogeneousbiological, environmental and sociological underpinnings, and by understanding thepsychiatric diseases beyond their classic symptomatic or syndromal definitionsusing OMICS research, one can have a broader picture and unprecedented links andreclassification of psychiatric nosology. Importantly, by understanding the basisof heterogeneity in diseases through OMICS research, one could also personalizetreatment of psychiatric illnesses.

In this manuscript, we discuss a gap in the current psychiatric research, namelythe missing logical link among OMICS, personalized medicine and reclassificationof diseases. Moreover, we explore the importance of incorporating OMICS-basedquantitative dimensional criteria, besides the classical qualitative andcategorical approach.

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Related in: MedlinePlus

Heat-map of psychiatric disease (where SAD stays for seasonal affectivedisorder). The color bar indicates the degree of genomic overlap betweena psychiatric disease and another (in terms of commonly shared genes), beingrepresented in light blue if weaker and in red if stronger.
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Figure 3: Heat-map of psychiatric disease (where SAD stays for seasonal affectivedisorder). The color bar indicates the degree of genomic overlap betweena psychiatric disease and another (in terms of commonly shared genes), beingrepresented in light blue if weaker and in red if stronger.

Mentions: Other complex diseases (e.g., heart diseases, diabetes, asthma, hypertension) are infact characterized by the involvement of different genes. The possible connectionsamong different genes involved in our proposed psychiatome schema are shown inFigure 2, and the heat-map matrix depictingrelationships among the different psychiatric diseases is represented inFigure 3, with their respective gene onthologic (GO)functional enrichment in Figure 4. Delineating commonshared-genes and genomics-relationships among and between psychiatric diseases can beuseful in shaping the concept of “spectrum” disorder (as merely a staticbinary notion of “disease”) and preparation for use of the new DSM-V inpractice [31].


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

Bragazzi NL - Philos Ethics Humanit Med (2013)

Heat-map of psychiatric disease (where SAD stays for seasonal affectivedisorder). The color bar indicates the degree of genomic overlap betweena psychiatric disease and another (in terms of commonly shared genes), beingrepresented in light blue if weaker and in red if stronger.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4120773&req=5

Figure 3: Heat-map of psychiatric disease (where SAD stays for seasonal affectivedisorder). The color bar indicates the degree of genomic overlap betweena psychiatric disease and another (in terms of commonly shared genes), beingrepresented in light blue if weaker and in red if stronger.
Mentions: Other complex diseases (e.g., heart diseases, diabetes, asthma, hypertension) are infact characterized by the involvement of different genes. The possible connectionsamong different genes involved in our proposed psychiatome schema are shown inFigure 2, and the heat-map matrix depictingrelationships among the different psychiatric diseases is represented inFigure 3, with their respective gene onthologic (GO)functional enrichment in Figure 4. Delineating commonshared-genes and genomics-relationships among and between psychiatric diseases can beuseful in shaping the concept of “spectrum” disorder (as merely a staticbinary notion of “disease”) and preparation for use of the new DSM-V inpractice [31].

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Health Sciences, School of Public Health, University of Genoa, Italy. nicola@genethics.ethicsoft.it

ABSTRACT

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is universallyacknowledged as the prominent reference textbook for the diagnosis and assessmentof psychiatric diseases. However, since the publication of its first version in1952, controversies have been raised concerning its reliability and validity andthe need for other novel clinical tools has emerged. Currently the DSM is in itsfourth edition and a new fifth edition is expected for release in 2013, in anintense intellectual debate and in a call for new proposals.

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

OMICS sciences, being based on high-throughput technologies, are systems biologyrelated fields (like genomics, proteomics, transcriptomics and so on). In theframe of the P5 medicine (personalized, participatory, predictive, preventive,psycho-cognitive), they could establish links between psychiatric diseases, whichare disorders with a final common symptomatology with vastly heterogeneousbiological, environmental and sociological underpinnings, and by understanding thepsychiatric diseases beyond their classic symptomatic or syndromal definitionsusing OMICS research, one can have a broader picture and unprecedented links andreclassification of psychiatric nosology. Importantly, by understanding the basisof heterogeneity in diseases through OMICS research, one could also personalizetreatment of psychiatric illnesses.

In this manuscript, we discuss a gap in the current psychiatric research, namelythe missing logical link among OMICS, personalized medicine and reclassificationof diseases. Moreover, we explore the importance of incorporating OMICS-basedquantitative dimensional criteria, besides the classical qualitative andcategorical approach.

Show MeSH
Related in: MedlinePlus