Personalised medicine and mental health

Personalised medicine is a medical model that tailors treatment to individuals based on genetic, epigenomic, and clinical information (Mathur & Sutton, 2017). Also called precision medicine (Boguski et al., 2009), P4 medicine (Flores et al., 2013) or stratified medicine (Trusheim et al., 2007), it is anticipated to have a major effect on both the development …

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Mental disorders in high versus low income countries

Psychiatric epidemiology studies the distribution and causal mechanisms of mental disorders in the population (McQuistion, 2008). It is a branch of epidemiology with its own set of challenges, including difficult assessment of caseness, high comorbidity, complex measurement of risk-factors such as stress or lack of social support, costly diagnostics, and information bias (Burger & Neeleman, …

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How effective are early interventions in psychosis services?

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), psychosis is a common symptom in a spectrum of psychotic disorders including schizophrenia and delusional disorder (American Psychiatric Association, 2013; Arciniegas, 2015). Classified as a clinical syndrome rather than a nosological entity (or distinct disease), psychosis is characterised by clinical features such as …

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Schizophrenia and dendritic spines

Pyramidal neurons are the primary type of cells in the cerebral cortex; they are made of a cell body called soma, a single axon, an apical dendrite, multiple basal dendrites, and dendritic spines (Megias et al., 2001). Dendritic spines are small neuronal protrusions rising from a neuron’s dendrites; they typically receive excitatory input from one …

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Schizophrenia and dopamine

Schizophrenia is a mental disorder causing a range of psychological symptoms such as delusions, hallucinations, disordered thinking, and abnormal motor behaviour, and which is considered by many as a neurodevelopmental disorder (Murray & Lewis, 1987; Weinberger, 2003). It affects 0.5–1% of the worldwide population, with a common onset in late adolescence to early adulthood (Perälä …

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The origins of the monoamine hypothesis of depression

Depression is a mental disorder characterised by clinical symptoms including low mood, rumination, functional impairment, retardation, and somatic syndromes such as sleep disturbances and loss of appetite (Lorr et al., 1967). Antidepressants were serendipitously discovered in the 1950s, when Iproniazid, a drug originally prescribed as a treatment for tuberculosis, was shown to induce increased vitality …

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Your brain on cortisol

In humans, stress can be defined as an actual or anticipated disruption of homeostasis in an individual (Ulrich-Lai & Herman, 2009). The brain plays a central role in the experience of stressful events and the regulation of stress: it adapts to stress both functionally and structurally, and dictates how individuals cope with stress (McEwen & …

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What’s the impact of deinstitutionalisation on patient outcomes?

Deinstitutionalisation – which can be defined as the diversion of people with a mental disorder to community mental health services, reducing the population of psychiatric hospitals, the number of psychiatric bed-days, and broadening the responsibilities of other service entities such as general hospitals and residential care (Bachrach, 1989) – started in Italy in the 1960s …

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Randomised controlled trials in psychotherapy research

Randomised controlled trials (RCTs) are considered one of the most rigorous and scientific methodologies to determine whether a cause-effect relationship exists between treatment and outcome, allowing researchers to exclude the possibility that the association was caused by an alternative factor (Sibbald & Roland, 1998). The random allocation to intervention groups, or randomisation, renders the groups …

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Theory of mind and autism spectrum disorder

Theory of mind (Premack & Woodruff, 1978) is the ability to understand the contents of another person’s mind, including their knowledge, emotions, beliefs, and intentions (Kloo et al, 2010). It is essential for social cognition (Astington & Edward, 2010), referential communication (Sidera et al, 2018), and better theory of mind is associated with better social interaction skills …

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