Portal de Periódicos da CAPES

The disordered mind

2011; Elsevier BV; Volume: 16; Issue: 1 Linguagem: Inglês

10.1016/j.tics.2011.12.004

1879-307X

Stavroula Kousta,

Mental Health Research Topics

One in four individuals will have a mental disorder at some point in their lives and approximately 10% of the population suffers from a mental disorder at any one time [1World Health Organization The World Health Report 2001. WHO, 2001Google Scholar]. The societal and personal burden of mental illness is enormous: mental disorders are leading causes of burden of disease, surpassing both cancer and cardiovascular disease [2World Health Organization The Global Burden of Disease: 2004 Update. WHO, 2004Google Scholar]. Yet, almost half of the world's population lives in a country where there is on average one psychiatrist per 200,000 people, spending on mental health is less than two US dollars per person annually, and institutional care for mental disorders may be decreasing worldwide [3World Health Organization Mental Health Atlas 2011. WHO, 2011Google Scholar]. And, in addition to the health burden of a mental disorder, people with a mental health condition face stigmatization, discrimination and exclusion [4World health Organization Mental Health and Development: Targeting People with Mental Health Conditions as a Vulnerable Group. WHO, 2011Google Scholar]. Two coordinated special issues in Trends in Cognitive Sciences and Trends in Neurosciences jointly address our current understanding of the biological basis of neuropsychiatric disorders, efforts to develop effective treatments, as well as societal issues. Disturbances in cognitive and emotional processes are hallmarks of neuropsychiatric disorders. Eight review articles in this special issue address the mechanisms and neural basis of cognitive and emotional impairments in a variety of disorders, including schizophrenia, attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), autism, major depressive disorder (MDD), bipolar disorder (BD), psychopathy, addiction, and eating disorders. The first six review articles address the neural basis of cognitive and emotional disturbances in specific disorders. Castellanos and Proal highlight a novel, systems-based, approach to ADHD, which attempts to characterize dysfunctions associated with the disorder in the context of large-scale brain networks, hence providing a mechanistic framework for understanding key aspects of ADHD. Barch and Ceaser discuss our current understanding of cognitive dysfunction in schizophrenia, focusing on three key domains: context processing, working memory and episodic memory. They propose a unifying account of deficits in all three domains based on the concept of proactive control: the ability to actively represent goal information in working memory to guide behavior. In a related contribution, Minzenberg and Carter discuss the range of treatments currently available for remediating impaired cognitive function in schizophrenia, including both pharmacological and non-pharmacological interventions. Milad and Rauch address the neural basis of obsessive-compulsive disorder, concluding that that the disorder involves impairments not only in cortico-striatal circuits, but also in an extended network of regions that are involved in fear extinction. Anderson and Kiehl characterize the psychopathology of psychopathy, discuss the brain regions linked to psychopathic behavior and highlight current theoretical efforts to account for the anatomofunctional findings obtained with neuroimaging studies of psychopathic populations. Price and Drevets address the neural basis of impaired emotional and cognitive processing in mood disorders (MDD and BD). They integrate findings from human and animal studies that delineate an extended network of regions as underlying the emotional and cognitive impairments in these disorders. This network includes the medial prefrontal cortex and anatomically related limbic, striatal, thalamic and basal forebrain structures. The final two review articles overview novel approaches to psychiatric research. Montague et al. summarize the objectives and value of computational approaches to mental disorders, as a means of linking findings at the molecular level to behavior. Robbins et al. propose a dimensional approach to psychiatry based on neurocognitive endophenotypes, according to which, changes in behavioural or cognitive processes are associated with discrete deficits in defined neural systems. They focus on the constructs of impulsivity and compulsivity, demonstrating their cross-diagnostic significance and applying them to co-morbidities and commonalities across a range of disorders. This special issue also sees the launch of a number of new formats in the journal: Spotlight, TrendsTalk and Forum articles. Spotlights explore the implications of recently published primary research articles, providing TiCS readers with another tool for keeping abreast with exciting developments in the field. TrendsTalk articles feature interviews with cognitive scientists, who provide personal insight into their career paths and fields of research, while Forum articles address issues of broad significance, highlighting novel developments or discussing long-standing questions, issues and debates. In this issue, four Spotlight articles discuss ‘hot off the press’ findings in neuropsychiatric research, including research that addresses the biological basis of dyslexia (see contribution by Kraus), the link between genetics and response to psychosocial treatment of mental disorders (see Spotlight by Beevers and McGeary), the contribution of a neural network model to understanding the neural basis of obsessive-compulsive disorder (see article by Maia and McClelland), and the neural mechanisms underlying dysfunction in individuals with Tourette syndrome (see Spotlight by Greene and Schlaggar). In the first TrendsTalk interview published in the journal, Steven E. Hyman discusses his career in psychiatry and the current status of research and diagnostic tools in the field, and provides an insider's perspective for those interested in entering the field of psychiatric research. A Forum piece by Panksepp and Solms summarizes the aims and achievements of the field of neuropsychoanalysis: a field that integrates psychoanalytic insights into the neuroscience of mental illness. Finally, in a Science and Society article, Wahl explains how widespread the social stigma associated with mental disorders is and how detrimental it can be for patient outcomes. In the TiNS special issue, you can find a broad selection of articles that cover basic neuroscience aspects of neuropsychiatric disorders, as well as discussions of neuropsychiatric research not touched upon in the TiCS issue (such as the neural circuitry implicated in posttraumatic stress disorder, the neurobiology of anhedonia, and the origins of suicidal behavior). Although far from exhaustive, we hope that, collectively, the articles in these two special issues provide a window into the most exciting aspects of neuropsychiatric research at the moment and glimpses into how the field is likely to develop in the next few years. We are very grateful to all authors and reviewers for their contributions to these two special issues. All articles will be freely available on the TiCS (www.cell.com/trends/cognitive-sciences) and TiNS (www.cell.com/trends/neurosciences) websites through the month of January 2012.