Jakovljevic Miro, Borovecki Fran
University Hospital Centre Zagreb, Department of Psychiatry, Kišpatićeva 12, 10000 Zagreb, Croatia,
Psychiatr Danub. 2018 Sep;30(3):242-253. doi: 10.24869/psyd.2018.242.
Personalized or precision medicine is a relatively new promising concept which is gaining momentum in all branches of medicine including psychiatry and neurology. Psychiatry and neurology are medical specialties dealing with diagnosis, prevention and treatment of brain disorders which are the main causes of years lived with disability worldwide as well as shortened life. Despite a huge progress in clinical psychopharmacology and neuropharmacology, the treatment outcome for many psychiatric disorders and neurologic diseases has remained unsatisfactory. With aging, comorbidities are more the rule, than an exception and may significantly influence on the final treatment outcome. Epigenetic modulation, resilience and life style are key determinants of the health and very important issues for understanding therapeutic mechanisms and responses. There is a hope that epigenetic profiling before treatment could be used in near future to increase the likelihood of good treatment response by selecting the appropriate medication. The aim of this paper is to offer an overview of the main aspects of epigenetic modulation, resilience and comorbidities and their role in developing the concept of personalized medicine. While waiting for more precise and reliable treatment guidelines it is possible to increase treatment effectiveness in psychiatry and neurology by enhancing individual resilience of patients and managing comorbidities properly.
个性化医疗或精准医疗是一个相对较新且前景广阔的概念，它在包括精神病学和神经病学在内的所有医学领域都日益受到关注。精神病学和神经病学是处理脑部疾病诊断、预防和治疗的医学专业，而脑部疾病是全球残疾生存年限以及缩短寿命的主要原因。尽管临床精神药理学和神经药理学取得了巨大进展，但许多精神疾病和神经疾病的治疗效果仍不尽人意。随着年龄增长，合并症更为常见，而非例外情况，并且可能对最终治疗效果产生重大影响。表观遗传调控、恢复力和生活方式是健康的关键决定因素，也是理解治疗机制和反应的非常重要的问题。人们希望在不久的将来，治疗前的表观遗传分析能够通过选择合适的药物来提高良好治疗反应的可能性。本文旨在概述表观遗传调控、恢复力和合并症的主要方面及其在发展个性化医疗概念中的作用。在等待更精确可靠的治疗指南的同时，通过增强患者的个体恢复力和妥善管理合并症，可以提高精神病学和神经病学的治疗效果。
