Aryutova Katrin, Paunova Rositsa, Kandilarova Sevdalina, Todeva-Radneva Anna, Stoyanov Drozdstoy
Department of Psychiatry and Medical Psychology, Scientific Research Institute, Medical University of Plovdiv, Plovdiv 4002, Bulgaria.
World J Psychiatry. 2021 May 19;11(5):169-180. doi: 10.5498/wjp.v11.i5.169.
Traditional therapeutic methods in psychiatry, such as psychopharmacology and psychotherapy help many people suffering from mental disorders, but in the long-term prove to be effective in a relatively small proportion of those affected. Therapeutically, resistant forms of mental disorders such as schizophrenia, major depressive disorder, and bipolar disorder lead to persistent distress and dysfunction in personal, social, and professional aspects. In an effort to address these problems, the translational approach in neuroscience has initiated the inclusion of novel or modified unconventional diagnostic and therapeutic techniques with promising results. For instance, neuroimaging data sets from multiple modalities provide insight into the nature of pathophysiological mechanisms such as disruptions of connectivity, integration, and segregation of neural networks, focusing on the treatment of mental disorders through instrumental biomedical methods such as electro-convulsive therapy (ECT), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS) and deep brain stimulation (DBS). These methodologies have yielded promising results that have yet to be understood and improved to enhance the prognosis of the severe and persistent psychotic and affective disorders. The current review is focused on the translational approach in the management of schizophrenia and mood disorders, as well as the adaptation of new transdisciplinary diagnostic tools such as neuroimaging with concurrently administered psychopathological questionnaires and integration of the results into the therapeutic framework using various advanced instrumental biomedical tools such as ECT, TMS, tDCS and DBS.
精神病学中的传统治疗方法，如精神药理学和心理治疗，帮助了许多患有精神障碍的人，但从长期来看，事实证明，这些方法仅对相对少数的患者有效。在治疗方面，诸如精神分裂症、重度抑郁症和双相情感障碍等难治性精神障碍会导致个人、社交和职业方面持续的痛苦和功能障碍。为了解决这些问题，神经科学中的转化方法已开始纳入新的或改良的非常规诊断和治疗技术，并取得了令人鼓舞的成果。例如，来自多种模式的神经影像数据集为诸如神经网络连接性、整合性和分离性破坏等病理生理机制的本质提供了深入了解，重点是通过电休克疗法（ECT）、经颅磁刺激（TMS）、经颅直流电刺激（tDCS）和深部脑刺激（DBS）等仪器生物医学方法来治疗精神障碍。这些方法已产生了令人鼓舞的结果，但仍有待理解和改进，以提高严重和持续性精神病性及情感障碍的预后。本综述聚焦于精神分裂症和情绪障碍管理中的转化方法，以及新的跨学科诊断工具（如神经影像）与同时使用的精神病理学问卷的适配，以及如何使用ECT、TMS、tDCS和DBS等各种先进的仪器生物医学工具将结果整合到治疗框架中。
