期刊
WORLD JOURNAL OF PSYCHIATRY
卷 12, 期 5, 页码 651-667出版社
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.5498/wjp.v12.i5.651
关键词
Nomothetic network psychiatry; Depression; Mood disorders; Affective disorders; Inflammation; Oxidative and nitrosative stress; Neuro-immune
类别
资金
- Ratchadapiseksompotch Funds, Faculty of Medicine, Chulalongkorn University [RA61/050]
The current understanding of major depressive disorder (MDD) and bipolar disorder (BD) is riddled with controversies, but a new, data-driven machine learning method called nomothetic network psychiatry (NNP) provides a new direction for research.
The current understanding of major depressive disorder (MDD) and bipolar disorder (BD) is plagued by a cacophony of controversies as evidenced by competing schools to understand MDD/BD. The DSM/ICD taxonomies have cemented their status as the gold standard for diagnosing MDD/BD. The aim of this review is to discuss the false dogmas that reign in current MDD/BD research with respect to the new, data-driven, machine learning method to model psychiatric illness, namely nomothetic network psychiatry (NNP). This review discusses many false dogmas including: MDD/BD are mind-brain disorders that are best conceptualized using a bio-psycho-social model or mind-brain interactions; mood disorders due to medical disease are attributable to psychosocial stress or chemical imbalances; DSM/ICD are the gold standards to make the MDD/BD diagnosis; severity of illness should be measured using rating scales; clinical remission should be defined using threshold values on rating scale scores; existing diagnostic BD boundaries are too restrictive; and mood disorder spectra are the rule. In contrast, our NNP models show that MDD/BD are not mind-brain or psycho-social but systemic medical disorders; the DSM/ICD taxonomies are counterproductive; a shared core, namely the reoccurrence of illness (ROI), underpins the intertwined recurrence of depressive and manic episodes and suicidal behaviors; mood disorders should be ROI-defined; ROI mediates the effects of nitro-oxidative stress pathways and early lifetime trauma on the phenome of mood disorders; severity of illness and treatment response should be delineated using the NNP-derived causome, pathway, ROI and integrated phenome scores; and MDD and BD are the same illness.
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