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Computational Psychiatry & Decision-making

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Abstracts

  • pdf Complexity and Heterogeneity in psychiatric disorders.
  • Totah N, Akil H, Huys QJM, Krystal JH, MacDonald III AW, Maia TV, Malenka RC and Pauli WM
  • In: Computational Psychiatry: New Perspectives on Mental Illness, edited by A. D. Redish and J. A. Gordon. Strüngmann Forum Reports, vol. 20, J. Lupp, series editor. Cambridge, MA: MIT Press
  • Psychiatry faces a number of challenges, among them are the reconceptualization of symptoms and diagnoses, disease prevention, treatment development and monitoring of its effects, and the provision of individualized, precision medicine. Achieving these goals will require an increase in the biological, quantitative, and theoretical grounding of psychiatry. To address these challenges, psychiatry must confront the complexity and heterogeneity intrinsic to the nature of brain disorders. This chapter seeks to identify the sources of complexity and heterogeneity as a means of confronting the challenges facing the field. These sources include the interplay between genetic and epigenetic factors with the environment and their impact on neural circuits. Moreover, these interactions are expressed dynamically over the course of development and continue to play out during the disease process and treatment.

    We propose that computational approaches provide a framework for addressing the complexity and heterogeneity that underlie the challenges facing psychiatry. Central to our argument is the idea that these characteristics are not noise to be eliminated from diagnosis and treatment of disorders. Instead, such complexity and heterogeneity arises from intrinsic features of brain function and, therefore, represent opportunities for computational models to provide a more accurate biological foundation for diagnosis and treatment of psychiatric disorders. The challenges to be addressed by a computational framework include the following. First, it must improve the search for risk factors and biomarkers, which can be used toward primary prevention of disease. Second, it must help to represent the biological ground truth of psychiatric disorders, which will improve the accuracy of diagnostic categories, assist in discovering new treatments, and aid in precision medicine. Third, to be useful for secondary prevention, it must represent how risk factors, biomarkers, and the underlying biology change through the course of development, disease progression, and treatment process.