Precision Psychiatry : Using Neuroscience Insights to Inform Personally Tailored, Measurement-Based Care

Psychiatry is dedicated to understanding mental disorders and helping people struggling with them live fulfilling lives. Although current treatment modalities can be remarkably effective at improving patients' quality of life and mitigating the burden of symptoms for disorders like depression, bipolar disorder, or posttraumatic stress disorder, finding the right treatment for an individual can be a long and fraught process during which symptoms can worsen the risks associated with other health conditions. Precision psychiatry, as outlined in this groundbreaking book, presents a new path forward. By integrating findings from basic and clinical neuroscience, clinical practice, and population-level data, the field seeks to develop therapeutic approaches tailored for specific individuals with a specific constellation of health issues, characteristics, strengths, and symptoms. This guide harnesses the expertise of more than three dozen contributors in diverse areas of interest, including neuroimaging, electrophysiology, neurocognition, behavioral science, machine learning, and pharmacotherapy, to examine the current state of precision medicine in psychiatry and explore future areas of advancement. Numerous case examples illustrate and apply the principles of precision psychiatry to mood and anxiety disorders, as well as schizophrenia, in adult patients, emphasizing the push to develop biomarkers and algorithms that will identify subtypes of patients that may be underserved by conventional therapies. In these pages, educators, trainees, and clinicians will find the latest research in precise classification, treatment planning, and early identification across a spectrum of psychiatric disorders—and the foundation for a future where one-size-fits-all treatments are replaced by modalities optimized for individual patients across all stages of a disorder. "An estimated 970 million people worldwide experienced a mental or substance disorder in the past few years, and one in five people in the United States live with a mental disorder at some point in their lives. Progress in precision medicine in disciplines outside of psychiatry, such as oncology and cardiology, has inspired progress reflected in the contributions in this book. In these disciplines, biomarkers are combined with clinical features to stratify patients into subtypes that are more coherent than are overarching diagnostic categories. This approach allows for identifying subtypes that are underserved by available therapies and allows for developing novel therapies aimed at targets that are based on specific mechanisms that affect measurable outcomes and that are closer to underlying disease processes than are traditional clinical endpoints. This book illustrates timely advances emerging in precision medicine in psychiatry, focusing on mood and anxiety disorders as well as schizophrenia in adults. Contributors to this book have a common view that a neuroscience- and data-informed approach is required to advance precision medicine in psychiatry. This book includes case examples of the applications of the topics covered, and the last chapter discusses the critical role of neuroscience education in precision psychiatry. The authors represent a range of expertise and have played fundamental roles in the development of the discipline of precision psychiatry. Biomarkers in neuroimaging, electrophysiology, and peripheral serum, as well as variations in genetic markers, neurocognition, and behavior, are covered, as is the importance of computational approaches and machine learning. The authors also review the precise application of multiple treatment modalities that include pharmacotherapy, cognitive-behavioral therapy, neurostimulation, and cognitive training programs on the individual level. Finally, this book addresses issues of scalability and implementation, including the need for the tests to have analytic and clinical validity as well as clinical utility"-- Provided by publisher A Neural Circuit-Informed Taxonomy for Precision Psychiatry / Laura M. Hack, Tali M. Ball, and Leanne M. Williams -- The Future of Precision Transcranial Magnetic Stimulation in Psychiatry / Noah S. Philip, Amin Zandvakili, and Yosef A. Berlow -- Neural Mechanisms of Bipolar Disorder Toward Personalized Markers of Future Illness Risk / Mary L. Phillips -- Information Processing Impairments as Transdiagnostic Treatment Targets in Psychiatric Disorders / Sophia Vinogradov, Jyoti Mishra, Mor Nahum, and Ian S. Ramsay -- State-Sensitive Biomarkers of Specific Computational Processes for Monitoring Symptoms and Predicting Outcomes in People With Schizophrenia / Steven M. Silverstein, Docia L. Demmin, and Samantha I. Fradkin -- Using Inflammatory Biomarkers to Identify and Treat Transdiagnostic Subtypes in Psychiatric Disorders / Carolina Medeiros Da Frota Ribeiro, Jennifer C. Felger, Michael T. Treadway, David R. Goldsmith, Ebrahim Haroon, and Andrew H. Miller -- Pharmacogenetic Testing : A Tool for Precision Prescribing in Psychiatry / Chad A. Bousman, Malcolm P. Forbes, and Boadie W. Dunlop -- Treatment Prediction Biomarkers for Major Depressive Disorder / Matthew D. Sacchet, Christian A. Webb, and Diego A. Pizzagalli -- Translational Neurobiological Approaches to Precision Medicine for Fear and PTSD / Nathaniel G. Harnett, Antonia V. Seligowski, Daniel Pine, and Kerry J. Ressler -- Latent Variable-Based Predictive and Explanatory Disease Models / Martin P. Paulus -- Computational Cognitive Methods for Precision Psychiatry / Quentin J.M. Huys -- Toward Precision Cognitive-Behavioral Therapy via Reinforcement Learning Theory / Yael Niv, Peter Hitchcock, Isabel M. Berwian, and Gila Schoen -- Moving From Precision to Personalized Psychiatry Clinical Perspectives on the New Era / Giampaolo Perna, and Charles B. Nemeroff -- Preparing for the Future of Precision Psychiatry : The Critical Role of Neuroscience Education / David A. Ross, Joseph J. Cooper, Melissa R. Arbuckle, Ashley E. Walker, and Michael J. Travis

Psychiatry is dedicated to understanding mental disorders and helping people struggling with them live fulfilling lives. Although current treatment modalities can be remarkably effective at improving patients' quality of life and mitigating the burden of symptoms for disorders like depression, bipolar disorder, or posttraumatic stress disorder, finding the right treatment for an individual can be a long and fraught process during which symptoms can worsen the risks associated with other health conditions.

Precision psychiatry, as outlined in this groundbreaking book, presents a new path forward. By integrating findings from basic and clinical neuroscience, clinical practice, and population-level data, the field seeks to develop therapeutic approaches tailored for specific individuals with a specific constellation of health issues, characteristics, strengths, and symptoms.

This guide harnesses the expertise of more than three dozen contributors in diverse areas of interest, including neuroimaging, electrophysiology, neurocognition, behavioral science, machine learning, and pharmacotherapy, to examine the current state of precision medicine in psychiatry and explore future areas of advancement.

Numerous case examples illustrate and apply the principles of precision psychiatry to mood and anxiety disorders, as well as schizophrenia, in adult patients, emphasizing the push to develop biomarkers and algorithms that will identify subtypes of patients that may be underserved by conventional therapies.

In these pages, educators, trainees, and clinicians will find the latest research in precise classification, treatment planning, and early identification across a spectrum of psychiatric disorders—and the foundation for a future where one-size-fits-all treatments are replaced by modalities optimized for individual patients across all stages of a disorder.

What if the principles of precision medicine already at work in fields such as cardiology, oncology, and infectious diseasewhere biomarkers are combined with clinical features to tailor treatments to specific patientswere applied to psychiatry? It's a bold path forward, and one that Precision Psychiatry presents exhaustively. More than three dozen experts in areas of expertise ranging from neuroimaging, neurocognition, and pharmacotherapy to behavioral science and machine learning illustrate the push to develop biomarkers and algorithms that will identify subtypes of patients that may be underserved by conventional psychiatric therapies. Throughout the book, numerous case examples apply the principles of precision psychiatry to a spectrum of mood and anxiety disorders, as well as schizophrenia. Whether they are educators, trainees, or clinicians, readers will find the latest research in precise classification, treatment planning, and early identification in these pages, and a vision of a future where a one-size-fits-all approach gives way to tailored treatment based on integrating the scientific foundations of psychiatry with recent advances in the neurosciences, data sciences, and technology.