Top 4 changes in psychiatry since 2010
We’re living in the century of the brain. Every year, neuroscience researchers make discoveries that serve to shape — and reshape — our understanding of the human mind. These research advances have allowed clinicians to implement new treatment techniques, perform more accurate diagnoses and, ultimately, help their patients lead more fulfilling lives.
Here are the top four changes in psychiatry in the last five years:
1.The introduction of pharmacogenetic testing:
Prescribing medication for psychiatric disorders often requires an unfortunate amount of trial and error. After all, dozens of medications exist for common mental illnesses, such as anxiety and depression, and sometimes only one or two of them will adequately address the patient’s symptoms. Patients often need to try several medications (and combinations of medications) before they find something that treats their disorder while causing minimal side effects.
Clinicians are hoping that pharmacogenetic testing will make it easier to find the proper medication for each patient. With pharmacogenetic testing, clinicians use a blood or urine sample to examine a person’s unique genetic code. They then use this information to determine how well a patient can metabolize a certain medication and whether that medication will cause side effects. Since 2010, more and more mental health facilities are starting to offer pharmacogenetic testing to most effectively treat their patients.
2.The release of the DSM-5:
The Diagnostic and Statistical Manual of Mental Disorders, or DSM, is a diagnostic tool used by clinicians to evaluate psychiatric conditions. The first DSM was published in 1978 and has been gradually updated over the years to reflect a growing understanding of neuroscience and mental illness.
The fifth edition of the DSM was released in 2013 and recognizes several new disorders, including disruptive mood dysregulation disorder and premenstrual dysphoric disorder. It also contains a new specifier, “with mixed features,” that can be added to a depressive disorder (such as major depression) to indicate that the patient also experiences episodes of mania or hypomania without meeting the criteria for bipolar disorder. The DSM-5 also now recognizes that ADHD — previously thought of as a childhood disorder — can continue into adulthood.
With this new diagnostic manual, clinicians can make more accurate diagnoses and treat their patients more efficiently.
3.Optogenetics as a research tool:
Optogenetics is a fascinating new research technique that uses bursts of light to control neurons. (Note: These neurons must be genetically modified to respond to light — it’s not something scientists can do with any old brain cell.) Scientists have used this tool to stimulate pathways and shut down brain regions, allowing them to make numerous new discoveries about how the brain works. For instance, researchers have found that optogenetic stimulation of the medial prefrontal cortex can result in powerful antidepressant effects. The use of optogenetics has also revealed a group of neurons that may be responsible for schizophrenia as well as a neural pathway that may help relieve the symptoms of anxiety disorders.
Although clinicians are unlikely to ever use optogenetics in therapy — the technique is highly invasive — they may be able to benefit from the knowledge gained from the research community.
4.Bringing rTMS into the therapeutic sphere:
Repetitive transcranial magnetic stimulation, or rTMS, is a completely noninvasive technique in which a special magnet is used to stimulate (or depending on the magnetic frequency, suppress) specific brain regions. Researchers have been using rTMS to study the relationship between the brain and behavior since the 1980s, although clinicians are now starting to see the therapeutic value in rTMS as well.
Repetitive transcranial magnetic stimulation appears to have a promising future in the ability to treat depression — numerous studies have found that applying rTMS to the left prefrontal cortex results in an antidepressant effect. The research on rTMS in other neuropsychiatric disorders, such as schizophrenia, bipolar and substance abuse, has been mixed but is still encouraging. In 2013, several health insurance plans began to cover rTMS as a medical procedure.
The Sovereign Health Group prides itself on staying up to date with the latest neuroscience and psychology research. We are one of the few treatment providers to offer pharmacogenetic testing, a revolutionary technique that allows clinicians to determine which medication works best for which individual. For more information about our programs, please contact our 24/7 helpline.
Written by Courtney Lopresti, M.S. neuroscience, Sovereign Health Group writer