Psychosis Research. Where have we been & where are we going?

 
phenotype and genotype

The Institute of Psychiatry at The Maudsley is the largest centre for psychiatric research in Europe. Recently a group of leading researchers were tasked with summarising an area of research as it pertains to psychosis and psychopharmacology.

The outcome was a series of short lectures, delivered to a lively audience of psychiatrists, mental health workers and psychologists at The Maudsley. The lecture slides and audio are now available below and constitute a unique training resource for those who treat patients.

1. Sir Robin Murray,
Psychosis research: Deconstructing the dogma
2. David Taylor,
Current Psychopharmacology: Facts & Fiction
3. Oliver Howes,
How can we Treat psychosis better?
4. Marta DiForti,
An idiot's guide to psychiatric genetics
5. Sameer Jauhar,
Ten psychosis papers to read before you die!
6. Paul Morrison,
Future antipsychotics

 

Cool Memories: The Recurring Crisis of Psychiatry.

The diagnostic system for delineating psychiatric disorders ('The DSM') is in it's fifth rewrite. It had been anticipated that advances in fMRI imaging and molecular genetics would have finally put psychiatric diagnoses on a medical footing. Alas fMRI has failed to live up to it's promise. And genetics, if anything, has been too powerful – by toppling the whole framework of DSM.

A new paper by Juan & Maria-Ines Lopez-Ibor captures the zeitgeist, but also reveals that the current debates and controversies are nothing new. For over 150 years, psychiatry/psychology has struggled to establish itself as a natural science because of three major issues – 1. Classification difficulties. 2. The mind-brain duality problem. 3. The perils of phrenology (localisationism).

[The full paper can be read here].

These issues have been acknowledged many times before, but never as a collective – and perhaps never as elegantly (even with some minor errors of translation from Spanish into English).

On classification…

“Psychopathological phenomena certainly exist and can be observed and experienced as such. However, psychiatric diagnoses are arbitrarily defined and do not exist in the same sense as psychopathological phenomena do”.

On dualism…

“Dualism manifests itself in the separation of mental and physical diseases, of psychiatry and the rest of medicine, of neuroses and psychosis, of biological research and interventions from other psychosocial approaches and in the proliferation of psychiatric sub-disciplines”.

& on phrenology (localisationism)…

“A phrenological approach still survives in neurological and psychiatric research…This approach has been extended to the neuropharmacology attributing specific neurotransmitters psychological functions”.

The text may be gloomy, for some. Others may engage in playful delight at references to Plato, Greisinger and the Upanishads. A follow up paper is in press (this was part 1), and much is promised…

“Modern science and modern medicine are, no doubt, the greatest achievements of humankind having change for the better of millions of human beings. We are not arguing to throw the baby with the water in the tub, but to look for fresh water to replace or replenish the existing one. This we will do in the second part of this article”.