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Eur Neuropsychopharmacol. 2014 Jan;24(1):5-50. doi: 10.1016/j.euroneuro.2013.09.010. Epub 2013 Oct 4.

Stratified medicine for mental disorders.

Author information

1
MRC-Social Genetic Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, PO80, 16 De Crespigny Park, London SE5 8AF, UK. Electronic address: gunter.schumann@kcl.ac.uk.
2
Max Planck Institute of Psychiatry, Munich, Germany.
3
Norwegian Institute of Public Health, Oslo, Norway.
4
Department of Endocrinology and Metabolism, Leiden University Medical Centre and Medical Pharmacology, LACDR, Leiden University, The Netherlands.
5
Department of Clinical Medicine, Section of Psychiatry, University of Bergen and Psychiatric division, Health Bergen, Norway.
6
Behavioural and Clinical Neuroscience Institute and Department of Psychology, Cambridge University, Cambridge, UK.
7
MRC-Social Genetic Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, PO80, 16 De Crespigny Park, London SE5 8AF, UK.
8
Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
9
Department of Psychology, University of St Andrews, St Andrews, UK.
10
Department of Cognitive Neuroscience, University Medical Center, St Radboud and Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands.
11
Department of Experimental Medicine and Public Health, University of Camerino, Camerino, Macerata, Italy.
12
Donders Institute, Nijmegen, The Netherlands.
13
Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain.
14
Department of Psychiatry and Psychotherapy, Medical University Innsbruck, Innsbruck, Austria.
15
Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
16
Wellcome Trust Centre for Neuroimaging, University College London, London, UK.
17
Berlin School of Mind and Brain, Bernstein Center for Computational Neuroscience (BCCN), Clinic for Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany.
18
Technische Universität Dresden, Department of Psychology, Dresden, Germany.
19
Cognitive Neuroscience, KarolinskaInstitutet, Stockholm, Sweden.
20
Division of Molecular Psychiatry, Laboratory of Translational Neuroscience, University of Würzburg, Würzburg, Germany and Department of Neuroscience, School of Mental Health and Neuroscience (MHENS), Maastricht University, Maastricht, The Netherlands.
21
University of Manchester, Manchester, UK.
22
Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
23
Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany.
24
Institut National de la Santé et de la Recherche Médicale, INSERM CEA Unit 1000 "Imaging & Psychiatry", University Paris Sud, Orsay; AP-HP Department of Adolescent Psychopathology and Medicine, Maison de Solenn, University Paris Descartes, Paris, France.
25
Psychiatric University Hospital, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
26
Department of Pharmacology, Biocenter Niederursel, University of Frankfurt, Frankfurt, Germany.
27
Neuropsychopharmacology Unit, Division of Brain Sciences, Imperial College, London, UK.
28
Child and Adolescent Neuropsychiatry Unit & Laboratory of Molecular Psychiatry and Neurogenetics, University Campus Bio-Medico, Rome, Italy.
29
Department of Psychiatry, University of Pisa, Pisa, Italy.
30
Institut du Cerveau et de la Moelle épinière (ICM), Hôpital de la Pitié-Salpêtrière, Paris, France.
31
Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University of Halle-Wittenberg, Halle/Saale, Germany.
32
Institute of Cognitive Neuroscience, University College London, London, UK.
33
Department of Geriatrics, Neuroscience & Orthopaedics, Catholic University of Sacred Heart, Policlinico A. Gemelli, Rome, Italy.
34
Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland.
35
Laboratory of Behavioural Genetics, Brain Mind Institute, EPFL, Lausanne, Switzerland.
36
Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland.
37
Bipolar Disorders Programme, Institute of Neuroscience, Hospital Clínic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain.
38
Leiden Institute for Brain and Cogntion/Psychiatric Neuroimaging, Dept. of Psychiatry, Leiden University Medical Center, The Netherlands.
39
Department of Psychology, Institute of Psychiatry, King's College London, UK.
40
Parc Sanitari Sant Joan de Déu, University of Barcelona, CIBERSAM, Barcelona, Spain.
41
Institute of Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany.

Abstract

There is recognition that biomedical research into the causes of mental disorders and their treatment needs to adopt new approaches to research. Novel biomedical techniques have advanced our understanding of how the brain develops and is shaped by behaviour and environment. This has led to the advent of stratified medicine, which translates advances in basic research by targeting aetiological mechanisms underlying mental disorder. The resulting increase in diagnostic precision and targeted treatments may provide a window of opportunity to address the large public health burden, and individual suffering associated with mental disorders. While mental health and mental disorders have significant representation in the "health, demographic change and wellbeing" challenge identified in Horizon 2020, the framework programme for research and innovation of the European Commission (2014-2020), and in national funding agencies, clear advice on a potential strategy for mental health research investment is needed. The development of such a strategy is supported by the EC-funded "Roadmap for Mental Health Research" (ROAMER) which will provide recommendations for a European mental health research strategy integrating the areas of biomedicine, psychology, public health well being, research integration and structuring, and stakeholder participation. Leading experts on biomedical research on mental disorders have provided an assessment of the state of the art in core psychopathological domains, including arousal and stress regulation, affect, cognition social processes, comorbidity and pharmacotherapy. They have identified major advances and promising methods and pointed out gaps to be addressed in order to achieve the promise of a stratified medicine for mental disorders.

KEYWORDS:

Mental disorder; Neural processes; Psychopathology; Roadmap; Stratified medicine; Treatment

PMID:
24176673
DOI:
10.1016/j.euroneuro.2013.09.010
[Indexed for MEDLINE]
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