We read with considerable interest Dr. Nasrallah’s April editorial (“Pleiotropy of psychiatric disorders will reinvent DSM,” Current Psychiatry, April 2013, p. 6-7; http://bit.ly/1DPgxZ7) that outlined his inspiring vision for the future of psychiatric diagnosis and assessment. We agree that by unraveling the neurobiologic underpinnings of psychiatric brain disorders, we will not only uncover the pleiotropic nature of these conditions but also transform our field into a clinical neuroscience.
In any given year, >1 in 4 Americans will have a diagnosable psychiatric condition.1 Psychiatric disorders remain the most prevalent cause of disability in the United States,2 and their enormous personal, economic, and societal impact fuels the tremendous impetus to seek scientific advances in diagnosis and treatment.
Many have suggested that the mind is too complex to undergo formal scientific study, but it is the nuanced appreciation of the elegant, yet complex workings of the brain that attracts brilliant minds to psychiatry and neuroscience. The leading neuroscientific advances in fields such as optogenetics, epigenetics, psychoneuroimmunology, and psychopharmacology continue to be spearheaded by psychiatrist-scientists. Understanding brain function continues to be a high priority, exampled by the April 2013 announcement of $100 million for President Obama’s BRAIN (Brain Research through Advancing Innovative Neurotechnologies) initiative.3
All of our psychiatric treatment modalities—including psychotropics, neuromodulation, and psychotherapy—are believed to promote synaptic plasticity, neurogenesis, and alterations in neuronal circuitry. Ensuring these concepts and advances are communicated to our residents, medical students, and patients remains paramount. Psychiatry has an immense and flourishing scientific and societal impact. Millions of people are affected by brain disorders, including autism, schizophrenia, and dementia. These patients and their families are counting on psychiatrists to elucidate the workings of the body’s most complex organ.
Arshya Vahabzadeh, MD
Laughlin Fellow, American College of Psychiatrists
Chicago, IL
PGY-3 Resident
Emory University School of Medicine
Atlanta, GA
Mizrab Khan, MRCPsych
Psychiatry Trainee, National Health Service
London, UK
David Buxton, MD
Fellow, Child and Adolescent Psychiatry
Massachusetts General Hospital
McLean Hospital
Harvard Medical School
Boston, MA
Leadership Fellow, American Psychiatric Association
Arlington, VA
References
1. Kessler RC, Chiu WT, Demler O, et al. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):
617-627.
2. World Health Organization [WHO]. The global burden of disease: 2004 update, table A2: Burden of disease in DALYs [disability-adjusted life year] by cause, sex and income group in WHO regions, estimates for 2004. http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_AnnexA.pdf. Accessed April 23, 2013.
3. The White House. Brain initiative. http://www.whitehouse.gov/infographics/brain-initiative. Accessed April 23, 2013.