Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada.
Eur Neuropsychopharmacol. 2022 Oct;63:17-34. doi: 10.1016/j.euroneuro.2022.08.001. Epub 2022 Aug 27.
Precision psychiatry is an emerging field with transformative opportunities for mental health. However, the use of clinical prediction models carries unprecedented ethical challenges, which must be addressed before accessing the potential benefits of precision psychiatry. This critical review covers multidisciplinary areas, including psychiatry, ethics, statistics and machine-learning, healthcare and academia, as well as input from people with lived experience of mental disorders, their family, and carers. We aimed to identify core ethical considerations for precision psychiatry and mitigate concerns by designing a roadmap for research and clinical practice. We identified priorities: learning from somatic medicine; identifying precision psychiatry use cases; enhancing transparency and generalizability; fostering implementation; promoting mental health literacy; communicating risk estimates; data protection and privacy; and fostering the equitable distribution of mental health care. We hope this blueprint will advance research and practice and enable people with mental health problems to benefit from precision psychiatry.
精准精神病学是一个新兴领域，为精神健康带来了变革性的机会。然而，临床预测模型的使用带来了前所未有的伦理挑战，在获得精准精神病学的潜在益处之前，这些挑战必须得到解决。本批判性评论涵盖了多学科领域，包括精神病学、伦理学、统计学和机器学习、医疗保健和学术界，以及来自精神障碍患者、他们的家人和照顾者的意见。我们旨在确定精准精神病学的核心伦理问题，并通过设计研究和临床实践的路线图来减轻人们的担忧。我们确定了优先事项：从躯体医学中学习；确定精准精神病学的应用案例；提高透明度和通用性；促进实施；促进心理健康素养；沟通风险估计；数据保护和隐私；以及促进精神卫生保健的公平分配。我们希望这一蓝图将推动研究和实践，使有心理健康问题的人受益于精准精神病学。
