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超越诊断——在现代神经科学中应用跨诊断方法和研究领域标准(RDoC)方面

[Beyond the diagnosis - applying the transdiagnostic approach and RDoC aspects in the modern neuroscience].

作者信息

Osváth Péter

机构信息

PTE Pszichiatriai es Pszichoterapias Klinika, Pecs, Hungary, E-mail:

出版信息

Psychiatr Hung. 2020;35(4):493-514.

PMID:33263299
Abstract

The new psychiatry classification systems, despite long lasting preparation and broad consensus, do not provide an answer to the fundamental dilemmas of modern psychiatry. This is because categorical approaches are independent of the underlying neurobiological and genetic factors and cannot integrate the results of modern research, which is a big barrier of the neuroscientific development. Recent neuroscience research, with revolutionary new methods and tools and the analysis of huge databases, provides more and more information about the normal and abnormal functioning of the central nervous system. It is an enor - mous challenge to interpret these new findings, so there is a growing need to develop theoretical models that help to better understand the complexity of mental disorders and the mechanism of their development. In my paper, I summarize recent research methods related to the symptomatic heterogenity and etiological back - ground of mental disorders and present the results of some new transdiagnostic studies, in order to illustrate the key aspects of the Research Domain Criteria (RDoC) system developed to integrate the new results. The RDoC framework helps to interpret the results of neuroscience research in a complex way and facilitates the detec - tion of differences in genotypes and (endo)phenotypes, as well as a better understanding of the pathophysiological mechanisms and developmental differences responsible for the development of mental disorders. This can mean signi ficant progress not only in renewing psychiatric nosology, but also in identifying new preventive and therapeutic targets.

摘要

新的精神病学分类系统,尽管经过了长期准备并达成了广泛共识,但并未解决现代精神病学的基本困境。这是因为分类方法独立于潜在的神经生物学和遗传因素,无法整合现代研究的结果,这是神经科学发展的一大障碍。最近的神经科学研究借助革命性的新方法、工具以及对海量数据库的分析,提供了越来越多关于中枢神经系统正常和异常功能的信息。解读这些新发现是一项巨大挑战,因此越来越需要开发理论模型,以帮助更好地理解精神障碍的复杂性及其发展机制。在我的论文中,我总结了与精神障碍症状异质性和病因背景相关的近期研究方法,并展示了一些新的跨诊断研究结果,以阐述为整合新成果而开发的研究领域标准(RDoC)系统的关键方面。RDoC框架有助于以复杂的方式解读神经科学研究结果,促进对基因型和(内)表型差异的检测,以及更好地理解导致精神障碍发展的病理生理机制和发育差异。这不仅可能意味着在更新精神病学分类学方面取得重大进展,还意味着在确定新的预防和治疗靶点方面取得重大进展。

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