McCutcheon Robert A, Cowen Philip, Nour Matthew M, Pillinger Toby
Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Oxford Health National Health Service Foundation Trust, Oxford, United Kingdom.
Biol Psychiatry. 2024 Dec 19. doi: 10.1016/j.biopsych.2024.12.004.
Pharmacological interventions are a cornerstone of psychiatric practice. The taxonomies used to classify these interventions influence the treatment and interpretation of psychiatric symptoms. Disease-based classification systems (e.g., antidepressant and antipsychotic) do not reflect the fact that psychotropic agents are used across diagnostic categories or account for the dimensional nature of both the psychopathology and biology of psychiatric illnesses. In this review, we discuss the history of psychotropic drug taxonomies and their influence on both clinical practice and drug development. We frame taxonomies as existing on a spectrum, with high-level disease-based approaches at one end and target-based molecular approaches at the other. Finally, we consider how data-driven methods might address the issue of classification at an intermediate level, based around transdiagnostic neurobiological and psychopathological markers.
药物干预是精神病学实践的基石。用于对这些干预措施进行分类的分类法会影响精神症状的治疗和解释。基于疾病的分类系统（如抗抑郁药和抗精神病药）并未反映出精神药物在不同诊断类别中都有使用这一事实，也未考虑到精神疾病的精神病理学和生物学的维度性质。在本综述中，我们讨论了精神药物分类法的历史及其对临床实践和药物研发的影响。我们将分类法视为存在于一个连续统一体上，一端是基于疾病的高级方法，另一端是基于靶点的分子方法。最后，我们思考数据驱动的方法如何围绕跨诊断神经生物学和精神病理学标志物在中间层面解决分类问题。
