Diseases of the mind and brain
Diseases of the mind and brain
复制标题
DOI：
10.1176/appi.ajp.159.7.1103
复制
发表时间：
2002-07-01
影响因子：
17.7
通讯作者：
Akbarian, S
中科院分区：
文献类型：
--
作者：
Akbarian, S
精神病学即将描绘出其主要疾病的组织机制。基因、蛋白质、神经系统、神经递质、遗传和个人生活经历的历史都将被编织在一起，以解释我们每天在病人身上看到的疾病表现。为了适应这一点，我们描述思想、意识、感觉和无意识等概念的心理术语将被扩充，以包括神经元结合、局部脑血流的激活/抑制模式和细胞内信号通路等神经概念。我们将学习人类行为影响大脑生物学的机制，以及中枢神经系统病理学如何改变行为。即使连接这两个领域的机制可以说是高度复杂的，这种情况也会发生。随着对心理现象的生物学关联的更好理解，我们的治疗方法--心理的和生物的--可能会更有效地构建。尽管在可预见的未来，细胞过程与行为/症状目标之间的联系仍将是一个经验过程，但药物仍将能够针对特定的细胞过程，我们所有人的任务仍然是跟上精神疾病的生物学事实，并观察它们如何相互融合。在精神病学中，我们将在未来几十年看到“生物”与“精神”的结合。然后，我们每个人都有责任将这些新发现融入我们对所治疗疾病的临床理解和日常实践中。这一问题标志着一个新的图像在神经科学系列的开始，“精神和大脑的疾病。”在这一系列中，我们将试图引导从业者注意目前的表述，遗传学，病理学，分子表现和精神疾病的治疗目标。新的信息将在几十年内发展，需要持续关注。当然，回报将来自于对人类精神、运动、认知和情感现象机制的发现和理解，以及我们利用这些知识来改善患者治疗。
Psychiatry is about to have the tissue mechanisms of its major illnesses delineated. The genes, the proteins, the neural systems, the neurotransmitters, the inheritance, and the history of individual life experience all will be woven together to explain the disease manifestations that we see daily in our patients. To accommodate this, our mental terms depicting concepts like mind, consciousness, feelings, and the unconscious will be augmented to include neural concepts like neuronal binding, activation/inhibition patterns of regional cerebral blood flow, and intracellular signaling pathways. We will learn the mechanisms whereby human behavior affects brain biology and how CNS pathology alters behavior. This will happen even though the mechanisms that join these two realms are, arguably, highly complex. As the biological correlates of psychological phenomena are better understood, our treatments—both psychological and biological—are likely to be more efficiently constructed. Medications will be able to be directed toward specific cellular processes, even though the link between the cellular processes and behavioral/symptomatic targets will remain an empirical process for the foreseeable future.It will remain a task for all of us to keep up with the biological facts about psychiatric illnesses and watch as they fit themselves together. In psychiatry, we will see in future decades the “biological” joining with the “mental.” Then it will be up to each one of us to fit these new discoveries into our own clinical understanding of the diseases we treat and into our everyday practice. This issue marks the beginning of a new Images in Neuroscience series,“Diseases of the Mind and Brain.” In this series, we will attempt to guide practitioner attention to current formulations of the presentation, genetics, pathology, molecular manifestations, and treatment targets of mental illnesses. New information will develop over decades and will demand sustained attention. The payoff, of course, will come with the discovery and understanding of mechanisms of human mental, motor, cognitive, and affective phenomena and our use of this knowledge to improve patient treatment.