Breaking Mental Illness's Code
Posted by everyminute - 11/11/08, 02:37 pmImagine mental illness, 2040. An eleven year old boy has a family history of bipolar disorder. A doctor's visit offers technology that determines the risk of developing a mental illness. The physician conducts a memory task together with brain imaging and a genetics test. The data is crunched in a computer that objectively concludes that the boy is highly at risk for, but has not developed, bipolar disorder. Given the boy's genetic make-up and various environmental and social factors in the boy's electronic medical record, a computer prints out an individualized treatment plan focused on preventing the development of bipolar. In subsequent visits, the boy is analyzed for the earliest hint of bipolar disorder even before symptoms begin to occur. If the illness does indeed develop, a specific and safe treatment plan is prepared based on the uniqueness of the boy's genetic make-up and environmental context. This individualized therapy does not merely control symptoms, but directly combats the onset and root of the illness. Throughout, his childhood is barely interrupted, and he gets along well in school.
Sound like pure fantasy? Well, I have to stop and confess. This whole paragraph has been stolen from a recent US News and World Report article about the understanding of the genetic underpinnings of illness as a giant step toward personalized medicine. However, the US News story was written about cancer. I just basically replaced any mention of cancer with a reference to bipolar disorder. But, this is to make a point.
The US News article describes "an entirely new approach to diagnosis and treatment: "personalized medicine," which looks to a patient's unique genetic differences to better understand his or her illness and tailor care." This revolution in diagnosis and treatment will bring about new discoveries, new therapies and new hope for cancer... AND mental illness.
The National Institute of Health reports that current mental health research is "discovering how individual differences in biology could determine how that person reacts to a certain medication. Discovering these individual differences will help improve both diagnosis and treatment. For a person with mental illness, one can imagine that in the future a physician would perhaps use a memory task together with brain imaging and a genetics test to diagnose and select a specific treatment — just as a contemporary cardiologist uses a stress test and echocardiogram to diagnose heart disease and select the proper treatment."
We are on the verge of significant advances that will move us closer to predictive, preventive, and personalized mental health care grounded in research. Genetics and neuroscience together are giving us the tools for predicting risk, validating diagnosis, and identifying targets for new, more effective treatments.
So, I hope my point has been made. Even though the media touts "personalized medicine" in the context of anything but mental illness, it applies here. Next time you see an article like "Breaking Cancer's Code," smile and take heart, because the same techniques, technologies and understanding apply to breaking mental illness's genetic code too. According to a recent article, "painstaking analysis of the DNA of thousands of patients has yielded important, and surprising, insights into the roots of schizophrenia, bipolar disorder, and autism." It is important to understand, however, that researchers are just beginning to put together the pieces of a huge jigsaw puzzle of psychiatric genetics. With further understanding and scientific discovery there indeed will be a revolution of diagnosis and treatment that will offer new hope, discoveries and new therapies. So, even if you don't read about it in national publications, know that mental health research is offering hope for a better tomorrow.





