Early Clinical Phenotypes, Clinical Staging, and Strategic Biomarker Research: Building Blocks for Personalized Psychiatry
2013; Elsevier BV; Volume: 74; Issue: 6 Linguagem: Inglês
10.1016/j.biopsych.2013.07.004
ISSN1873-2402
Autores Tópico(s)Mental Health Research Topics
ResumoPerhaps the greatest aspirational goal in 21st century psychiatry is to achieve the kind of personalized medicine that is already a reality in other domain areas of medical care. If achieved, it would go a long way to finally securing the century-old claim of psychiatry being a valid branch of medicine. This claim comes under constant threat, especially around the time of revisions of the Diagnostic and Statistical Manual of Mental Disorders. Paradoxically, both the desire to define the neurobiological underpinnings of mental ill health and the failure so far to characterize these in such a way as to guide treatment selection have been severely criticized. Yet, such an aspiration in no way diminishes the central value of psychological and social dimensions of illness and therapy. On the contrary, if fulfilled, it could add greatly to achieving the dream of a holistic preemptive psychiatry ( 1 Insel T.R. The arrival of preemptive psychiatry. Early Interv Psychiatry. 2007; 1: 5-6 Crossref PubMed Scopus (75) Google Scholar ). Cortisol Levels and Risk for Psychosis: Initial Findings from the North American Prodrome Longitudinal StudyBiological PsychiatryVol. 74Issue 6PreviewStudies of biomarkers of hypothalamic-pituitary-adrenal activity indicate that psychotic disorders are associated with elevated cortisol. This study examined cortisol levels in healthy control subjects and individuals who met clinical high-risk (CHR) criteria for psychosis. It was hypothesized that cortisol levels would be 1) elevated in the CHR group relative to control subjects, 2) positively correlated with symptom severity, and 3) most elevated in CHR patients who transition to psychotic level severity. Full-Text PDF
Referência(s)