Leboyer Marion, Llorca Pierre-Michel
Inserm U955 IMRB, Laboratoire Neuropsychiatrie Translationelle, AP-HP, Hôpital Henri Mondor, DMU IMPACT et Fédération hospitalo-universitaire de médecine de précision en psychiatrie (FHU ADAPT), Université Paris Est Créteil (UPEC), Fondation FondaMental, Créteil, France.
CHU Clermont-Ferrand, Département de psychiatrie, Université de Clermont-Auvergne, CNRS, Clermont-Auvergne INP, Institut Pascal, Clermont-Ferrand, France.
Med Sci (Paris). 2025 May;41(5):411-415. doi: 10.1051/medsci/2025064. Epub 2025 May 26.
Current psychiatry, based on categorical descriptions of diagnostic entities, defined by international diagnostic manuals, is moving from this "one size fits all" strategy to a "precision psychiatry" that aims to be clinically informed by a dimensional, transdiagnostic perspective enriched by the use of objective, quantifiable and continuous markers such as omics, brain imaging, environmental and lifestyle variability of each individual. By recognizing the heterogeneity of existing categorical diagnostic entities, determined by the underlying biology, this approach aims to improve patient care. Precision medicine can be used to characterize and identify individuals with or at risk for a disorder, predict their prognosis, and make more specific choices of treatment strategies such as medications, psychological interventions, lifestyle rules, and/or brain stimulation, thereby improving prognosis and cost-effectiveness of the treatments.
当前基于国际诊断手册对诊断实体进行分类描述的精神病学,正从这种“一刀切”策略转向“精准精神病学”,该策略旨在从维度和跨诊断角度为临床提供信息,这种角度通过使用客观、可量化和连续的标志物(如组学、脑成像、每个人的环境和生活方式差异)得以丰富。通过认识到由潜在生物学因素决定的现有分类诊断实体的异质性,这种方法旨在改善患者护理。精准医学可用于对患有某种疾病或有患病风险的个体进行特征描述和识别,预测其预后,并对治疗策略(如药物治疗、心理干预、生活方式规则和/或脑刺激)做出更具体的选择,从而改善治疗的预后和成本效益。