The third are genetic risk factors. Certain genes are associated with an increased risk of developing a mental disorder. These risk genes are different from disease genes, which directly cause a disorder. Researchers have linked multiple risk genes to several mental disorders, and the effect each genetic variant has on developing a mental disorder is cumulative. Bundling these individual genetic variants into what’s called a polygenic risk score could offer a more comprehensive estimate of disease risk.
While genetic biomarkers are not ready for use in the clinic, integrating genetic and psychosocial risk factors can help psychiatry transition into the era of precision medicine.
Future of DSM
In 2013, psychiatrist Henry Nasrallah conducted an online survey of colleagues visiting the webpage of the journal Current Psychiatry, of which he was editor-in-chief. He wrote that 65 percent of respondents predicted the DSM-6 will include laboratory tests to diagnose psychiatric disorders and that he believed they might be right.
Thirteen years later, researchers are finally working to introduce biology to the DSM, one finding at a time.
The DSM isn’t perfect, but it offers a common language and conceptual framework for mental health clinicians to help support patients and their families over the long haul of mental illness.
While science reveals the inconvenient truth about how complex mental disorders are, I believe incorporating neuroscience into the DSM as the research advances will provide clinicians a more scientific and broader perspective on mental health. One day, patients may be able to walk into the clinic with results from genetic tests, brain scans and blood work that their health team can use to provide more precise diagnoses and personalized treatment.
That’s the dream I have for the future of psychiatry.
Anand Kumar is Professor and Department Head of Psychiatry at University of Illinois Chicago.
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