Citation

Fernandes BS, Borgwardt S, Carvalho AF, Steiner J. Front. Psychiatry 2020; 11: 112.

Affiliation

Department of Psychiatry, University of Magdeburg, Magdeburg, Germany.

Copyright

(Copyright © 2020, Frontiers Media)

DOI

10.3389/fpsyt.2020.00112

PMID

32174859

PMCID

PMC7054451

Abstract

Psychiatry, with the field of Precision Psychiatry, has been experiencing one of the most exciting moments of its history with a paradigmatic shift (1). A few years ago, it became clear that the understanding of psychiatry at the time, mostly descriptive and phenomenologically based, was wanting. This led to a crisis within the psychiatric community, and, some would say, a disbelief in the field; the simply phenomenologically driven paradigm of the time was no longer sufficient.

According to philosophy of science, when a paradigm is threatened by crisis, the community itself, in this case, the psychiatric community, with its clinicians and scientists, is in disarray. For instance, there are moving quotations from Wolfgang Pauli, one a few months before Heisenberg's matrix algebra, which was a major conceptual change in quantum mechanics, and one just some months after. In the former, Pauli expresses the feeling that physics is going to ruin, and he wishes he were in another field; a few months later, the way ahead is clear. At the time, many had the same feeling, and at the height of the crisis, the community was falling apart as the current paradigm was under questioning (2). Crisis and paradigm change go hand in hand; however, crisis does not, in itself, lead to rejection of the existing paradigm. The decision to reject one paradigm is invariable parallel to the decision to accept another, and the logic leading to that decision involves the comparison of both paradigms with each other. In this sense, precision psychiatry, by embracing the heterogeneity of psychiatric disorders, and thus aiming at predicting diagnosis, prognosis, and response to treatment for an unique individual by employing the underlying pathophysiology, as opposed to diagnosing and treating psychiatric disorders merely informed by the somehow subjective clinical characteristics of a patient, constitutes a new paradigm in psychiatry ...

Language: en

Keywords

biomarker; computational psychiatry; machine learning; mood disorders; personalized medicine; precision medicine; precision psychiatry; schizophrenia