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Precision medicine for psychosis: a revolution at the interface of psychiatry and neurology

Nature Reviews Neurology volume 19, pages 193–194 (2023)Cite this article

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A growing understanding of the neurobiology of psychosis offers hope for an improvement in the standard of care; this includes the development of individualized, precision therapeutics. However, the path to precision psychiatry is long, and progress would be accelerated by greater collaboration with the fields of neurology and neuroscience.

Most treatments in psychiatry are trial-and-error attempts to address clinical presentation — the field lacks objective diagnostic tests and treatment-responsive biomarkers. This exclusive reliance on clinical features for diagnosis hampers the improvement of psychiatric care. Because the field lacks valid treatment targets, in 2012 former NIMH Director Steve Hyman lamented a “stalled revolution” in psychiatric drug development1. In a Review in this issue, Fiona Coutts and colleagues propose that mingling clinical and biomarker assessments to generate predictive models will support ‘precision psychiatry’; that is, treatment tailored for specific patients. We support this aim and further propose that it will be achieved sooner with greater collaboration among neuroscience, neurology and psychiatry. We believe the field has a long journey before we achieve precision psychiatry and propose ways to progress towards this goal.

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Fig. 1: Psychiatry hopes to move on from one-size-fits-all diagnostics and treatment.

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Acknowledgements

The authors thank J. McDowell and V. Shashi for their valuable input.

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Authors and Affiliations

  1. Beth Israel Deaconess Medical Center, Boston, MA, USA

    Matcheri S. Keshavan

  2. Harvard Medical School, Harvard University, Boston, MA, USA

    Matcheri S. Keshavan

  3. Department of Psychology, University of Georgia, Athens, GA, USA

    Brett A. Clementz

  4. Department of Neuroscience, University of Georgia, Athens, GA, USA

    Brett A. Clementz

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  1. Matcheri S. Keshavan
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Correspondence to Matcheri S. Keshavan.

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Keshavan, M.S., Clementz, B.A. Precision medicine for psychosis: a revolution at the interface of psychiatry and neurology. Nat Rev Neurol 19, 193–194 (2023). https://doi.org/10.1038/s41582-023-00788-0

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