Chapter

Psychiatric Disorders

Joseph T. Coyle

in Principles of Drug Therapy in Neurology

Second edition

Published on behalf of Oxford University Press

Published in print September 2010 | ISBN: 9780195146837
Published online April 2013 | e-ISBN: 9780199322961 | DOI: http://dx.doi.org/10.1093/med/9780195146837.003.0742

Series: Contemporary Neurology Series

Psychiatric Disorders

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Since the previous edition of this chapter, the field of psychiatry has undergone a paradigm shift more dramatic than perhaps in any other area of medicine. Three major technical and conceptual advances account for this transformation. First, the tremendous advances in neuroscience research have provided a progressively more sophisticated understanding of brain development, neural systems functions and cognition.1 Perhaps the most compelling insight relevant to psychiatric disorders is that the brain is a remarkably plastic organ that exhibits both functional as well as structural changes as a consequence of environmental interactions and even mentation itself. Second, advances in brain imaging have permitted high-resolution measurement of brain structure, function, and chemistry.2–4 Quantitative morphometry has unequivocally demonstrated the distributed cortical pathology of schizophrenia as well as atrophy of the hippocampus in major depressive disorder and posttraumatic stress disorder, for example. Functional brain imaging has documented region and pathway specific abnormalities in neuronal activity in response to specific cognitive/emotional challenges in disorders as diverse as major depression, obsessive-compulsive disorder and schizophrenia. Finally, the human genome project has deeply affected psychiatry with compelling evidence that serious psychiatric disorders have a substantial genetic component.5 We now know that psychiatric disorders are likely due to complex genetics with multiple risk genes of modest effect interacting with environment to produce the phenotype. Putative risk genes for psychiatric disorders are being identified at an accelerating rate. The genetic deconstruction of psychiatric disorders will offer opportunities for pharmacologic interventions that are targeted at the molecular mechanisms responsible for components of psychiatric disorders so that in the future personalized medicine will likely affect psychiatry as much as other areas of medicine.

Chapter.  10453 words. 

Subjects: Neurology

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