Latimer: Taking the guesswork out of mental health

In an effort to shift research goals in psychiatry, the US National Institute of Mental Health (NIMH) will soon only be funding studies that aim to learn more about the neurobiological underpinnings of disorders.

Until the technological advances of recent years, psychiatric research and treatment has relied very heavily on alleviating symptoms in the absence of much concrete evidence about exactly how the brain works.

Thanks to today’s imaging techniques and a growing body of knowledge about the structure and function of the brain, we now have more opportunity to pinpoint what is happening within the brain to cause specific symptoms.

NIMH funds about $100 million in mental health research per year. Last year, more than half of those grants were given to studies with no requirement to examine biological processes.

One NIMH director believes this means there is nothing learned when a particular treatment fails – what results is a waste of time and funds.

To remedy this problem, NIMH has now declared future grants will be based on an experimental medicine approach.

This means studies funded by NIMH will have to do more than simply aim to alleviate symptoms.

In addition, they should also be working to glean more information about biological or neurological factors underlying disorders.

This is an important move and it signals a shift in thinking about psychiatry.

It is time for mental health to be treated just as physical health – not as an abstract subject shrouded in clinical guesswork, but as a scientific discipline focused on affecting specific changes in the brain.

This change will likely result in some backlash and perhaps concern about existing patients and our need to help them while we continue to seek out causes and mechanisms for each condition.

Continuing to provide new treatments that do work to alleviate symptoms is still important.

While I certainly agree we need to put patient needs first, I also strongly believe that it is possible to learn the biological mechanisms for psychiatric conditions and that doing so will lead to much more effective solutions in the long term.

Once we learn the subtle differences between different types of depression, anxiety or other conditions, we will be able to develop treatments targeted to specific biological traits.

These will likely be more effective at symptoms relief, will probably mean fewer unwanted side effects and will also take out the clinical guesswork involved in determining which medication will work best for an individual patient.

I think this move by the NIMH is a good one and I look forward to seeing what kinds of advances are made in our understanding of the human brain as a result.

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