Giordano Giulia Maria, Pezzella Pasquale, Perrottelli Andrea, Galderisi Silvana
Department of Psychiatry, University of Campania Luigi Vanvitelli.
Fortschr Neurol Psychiatr. 2020 Nov;88(12):767-772. doi: 10.1055/a-1211-2826. Epub 2020 Aug 31.
'Precision medicine' is defined as 'an emerging approach for treatment and prevention that takes into account each person's variability in genes, environment, and lifestyle'. Sometimes the term 'personalized medicine' is also used, either as a synonym or in a broader sense. In psychiatry, the term 'personalized' applies to different levels of health-care provision, such as the service organization and the choice of treatment plans based on the characterization of the individual patient. This approach is already feasible but, currently, it is often hampered by the shortage of human and financial resources. Recently, the terminology of 'precision medicine' has been extended to psychiatry: the term 'precision psychiatry' refers to the full exploitation of recent scientific and technological advances to achieve a close match between individual biosignature and prevention / treatment strategies. This article provides an overview of recent advances in neuroimaging, multi-omics and computational neuroscience, which have contributed to foster our understanding of the neurobiology of major mental disorders, and led to the implementation of a precision medicine-oriented approach in psychiatry.We argue that, while 'precision psychiatry' represents an important step to further advance the effectiveness of the 'personalized psychiatry', the distinction between the two terms is important to avoid dangerous neglect of the current potential of personalized care in psychiatry and to underscore the need for disseminating good existing practices aimed at organizing mental health services and providing care according to person's psychopathological characteristics, illness trajectory, needs, environment and preferences.In conclusion, 'precision psychiatry' will contribute to advance 'personalized psychiatry', but for the time being keeping the distinction between the two terms will contribute to fully exploit the current potential of personalized care.
“精准医学”被定义为“一种新兴的治疗和预防方法，它考虑到每个人在基因、环境和生活方式方面的差异”。有时也会使用“个性化医学”这个术语，要么作为同义词，要么在更广泛的意义上使用。在精神病学中，“个性化”一词适用于不同层面的医疗服务提供，比如服务组织以及基于个体患者特征选择治疗方案。这种方法已经可行，但目前常常受到人力和财力资源短缺的阻碍。最近，“精准医学”的术语已扩展到精神病学领域：“精准精神病学”指充分利用最新的科技进展，以使个体生物特征与预防/治疗策略紧密匹配。本文概述了神经影像学、多组学和计算神经科学的最新进展，这些进展有助于增进我们对主要精神障碍神经生物学的理解，并促使在精神病学中实施以精准医学为导向的方法。我们认为，虽然“精准精神病学”是进一步提高“个性化精神病学”有效性的重要一步，但区分这两个术语很重要，以免危险地忽视精神病学中个性化护理的当前潜力，并强调需要推广现有的良好做法，即根据个人的精神病理特征、疾病轨迹、需求、环境和偏好来组织心理健康服务并提供护理。总之，“精准精神病学”将有助于推进“个性化精神病学”，但目前区分这两个术语将有助于充分挖掘个性化护理的当前潜力。
