In deciding on article topics for Cerebrum, the Dana Foundation’s online journal, an advisory board generally considers recent studies of merit, replication, and the potential of the research to have an impact on treatment.
Few topics seem to have more potential for impacting society than understanding the biology of depression, an elusive area of neuroscience that is the subject of “The Holy Grail of Psychiatry” in this month’s Cerebrum. According to the World Health Organization (WHO), 350 million people worldwide suffer from depression, a leading cause of disability. In the United States, 16 million adults, or 6.9 percent of the population, had at least one major depressive episode in 2012.
Charles B. Nemeroff, M.D., Ph.D., the Leonard M. Miller Professor at the University of Miami School of Medicine and a former president of American College of Psychiatrists, examines the impact of a 2013 groundbreaking study (led by Dana Alliance member and grantee Helen Mayberg at Emory University) that used brain-scanning techniques to identify several components of a complex neural circuit that becomes disordered in depressive illnesses.
Writing on this topic in the New York Times, Eric Kandel, a professor, Nobel Prize winner, and Dana Alliance member, claimed that it is often argued that psychiatry is a “semi-science” whose practitioners cannot base their treatment of mental disorders on the same empirical evidence as physicians who treat disorders of the body can. “The problem for many people is that we cannot point to the underlying biological bases of most psychiatric disorders,” he says. “In fact, we are nowhere near understanding them as well as we understand disorders of the liver or the heart. But that is starting to change.”
Both Kandel and Nemeroff believe that if Mayberg’s work could be advanced and replicated, psychiatrists could not only know whether a patient is better served by therapy or medication, but what type of medication to prescribe. The expanding area of genetics and pharmacogenetics in particular, adds Nemeroff, is also of vital importance.
“This is part of the ongoing and exciting scientific process that is emblematic of the marriage of neuroscience and psychiatry,” writes Nemeroff. “Ultimately, I believe this work will be judged as crucial in eventually attaining the goal all of us seek: a valid predictor of individual treatment response in depression, still the Holy Grail in psychiatry research.”
– Bill Glovin