Biological Psychiatry Disorder

Keller, Martin, Stuart Montgomery, William Ball, Mary Morrison, Duane Snavely, Guanghan Liu, Richard Hargreaves, Jarmo Hietala, Christopher Lines, Katherine Beebe and Scott Reines, Lack of Efficacy of the Substance P (Neurokinini Receptor) Antagonist Aprepitant in the Treatment of Major Depressive Disorder , Biological Psychiatry 59 (2006) 216-23... 

Bauer M et al. (2002). World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders. Part 1 Acute and continuation treatment of major depressive disorder. World Journal of Biological Psychiatry, 3, 5-43. 

Herpfer I and Lieb K (2003). Substance P and substance P receptor antagonists in the pathogenesis and treatment of affective disorders. World Journal of Biological Psychiatry, 4, 56-63. 

Miklowitz DJ, Simoneau TL, George EL, Richards JA, Kalbag A, Sachs-Ericsson N and Suddath R (2000). Family focused treatment of bipolar disorder 1 year effects of a psychoeducational programme in conjunction with pharmacotherapy. Biological Psychiatry, 48, 582-592. 

Freedman, D. X. (1973) Psychotomimetic agents and our understanding of psychiatric disorders. In Textbook of Biological Psychiatry, edited by J. Mendels, pp. 149-173. Wiley, New York. 

O Donnell, T., K.M. Hegadoren, and N. C. Coupland. Noradrenergic Mechanisms in the Pathophysiology of Post-traumatic Stress Disorder. Biological Psychiatry 50 (2004) 273-283. 

So far, however, boundaries have not been established and, even worse, no systematic attempts to do so are noticed. This hampers biological psychiatry and may well be among the reasons that the search for biological markers of psychiatric disorders over the past 35 years has been remarkably unsuccessful. A concrete example may illustrate this point a score of at least 16-18 on the Hamilton Depression Scale (M. Hamilton 1960] is generally accepted as a criterion to include someone in a depression study. One could, however. 

This principle is not applicable in biological psychiatry. One can and should not simply discard the possibility that a biological variable observed in a psychotic condition is linked to a concurrent depression or that one found in depression is in fact related to a comorbid anxiety disorder. The hierarchical principle is a deus ex machina that resolves the problem of comorbidity only in appearance. Comorbidity in itself is merely a descriptive, not an explanatory, term. The multiplicity of psychiatric disorders, as they are presently defined, in so many patients permits a variety of explanations (Van Praag 1996], and thus the term comorbidity conceals more than it discloses. 

Biological psychiatry, today, aims at elucidation of the biology of disease entities. This intention presumes the validity of those entities, but this premise is disputable. Many of the disease entities presently distinguished seem to represent, at best, basins of a variety of more or less comparable, but in many ways dissimilar, disorders. It is hard to believe that the search for particular brain dysfunctions underlying a diagnostic construct, representing in point of fact a diversity of disorders, stands much chance to score a success. 

Most psychiatric patients do not meet the criteria of one particular disorder as presently defined, but show signs and symptoms of a multitude of disorders, or rather they display a patchwork of parts of different disorders. This situation faces biological psychiatry with insurmountable problems in determining which of the disorders in a given patient is the behavioral correlate of a particular biological disturbance. The hierarchical principle as applied in the later DSM editions—albeit inconsistently— provides no more than an ostrich solution. The problems of comorbidity do not disappear by concealing them. 

The third reason to add a third tier to the diagnostic process is that it provides insight in the fundamental abilities of the patients. The fourth reason is the most important. From its inception as a scientific discipline, the nosological model has been, and still is, taken for granted in psychiatry. Psychiatric disorders are viewed as discrete entities, with a fixed and predictable set of attributes and distinguishable from adjacent disorders. Within the framework of this model, biological psychiatry searches for markers and, eventually, causes of true disease entities. 

Soldatos CR Computerized sleep EEG (CSEEG) in psychiatry and psychopharmacology, in Biological Psychiatry Today. Edited by Obiolo J, Ballus C, Monclus EG, et al. Amsterdam, Elsevier, 1979 Soldatos CR Insomnia in relation to depression and anxiety epidemiologic considerations. J Psychosom Res 38 [suppl l 3-8, 1994 Soldatos CR, Paparrigopoulos TJ Sleep patterns in depression, in WPA Teaching Bulletin on Depression. November [issue 11), 1995 Soldatos CR, Vela-Bueno A, Kales A Sleep in psychiatric disorders. Psychiatric Medicine 4[2) 119-132, 1987... 

The prototypes of modem psychopharmaceuticals were discovered between 1952 and 1958. Since that time the effective treatment of schizophrenic psychoses, depressions, anxiety syndromes and other mental disorders has become possible and a new, multidisciplinary science biological psychiatry has developed. Clinical psychiatry has changed dramatically in the past 50 years fewer patients are hospitalized long term, psychiatric care and treatment have largely shifted to outpatient departments and private practices, and new models of combined pharmacological and non-drug-based prophylactic and therapeutic interventions have been developed. 

Wolkow R, March J, Safferman A, et al. A placebo controlled trial of sertraline treatment for pediatric obsessive compulsive disorder. 6th World Congress of Biological Psychiatry 1997 42 213S-213S. 

Hyman, S.E. (1999) Introduction to the complex genetics of mental disorders. Biological Psychiatry 45, 518—21. 

Biological psychiatry is the discipline evaluating abnormalities in brain biology associated with the causes or consequences of mental disorders. True or False. 

Lader M (2002) Sleep disorders - therapeutic armamentarium. In H D Haenen, JA Den Boer, P Willner (eds) Biological Psychiatry. John Wiley, Chichester, 1307-1314... 

The potential association between the immune system and mood disorders has become a major topic of interest in biological psychiatry in the past decade. In general, three immune measures have been examined, namely white blood cell counts, functional measures of cellular immunity such as natural killer cell activity and immune cell markers as exemplified by human lymphoctye antigen (HLA). The cumulative data from these studies suggests that depressed patients have a decreased number of lymphocytes, reduced mitogen-induced lymphocyte proliferation and a reduction in the number of natural killer cells. However, this does not apply to all depressed patients. Furthermore, not all aspects of immune function... 

Surguladze, S., Brammer, M.J., Keedwell, P., Giampietro, V., Young, A.M., Travis, M.J., Wiliams, S.C., and Phillips. M.L. (2005). A differential pattern of neural response toward sad versus happy facial expression in major depressive disorder. Biological Psychiatry, 57, 21-209. 

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