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Initiatives in Integrative Mental Health: Page 2 of 5

Initiatives in Integrative Mental Health: Page 2 of 5

Improvements in the pharmacological management of mental illness and advances in manufacturing and quality assurance of vitamins, herbal supplements, amino acids, and other natural products will result in more effective and safer conventional and alternative treatment choices for psychiatric disorders. Protocols that incorporate validated mind-body and energy therapies will become widely used as preventive and treatment modalities.

Rapid evolution in biomedical psychiatry and CAM

Rapid evolution is taking place in both conventional biomedical psychiatry and CAM. Novel assessment and treatment approaches in biomedical psychiatry will emerge from ongoing advances in the basic neurosciences, functional brain imaging, immunology, and genetics. Future models of mental illness causation will not depend exclusively on empirical verification of strictly biological processes and will postulate both classically described biological and biophysical causes (eg, genetic factors and neurotransmitter dysregulation) as well as nonclassical phenomena (eg, nonlinear brain dynamics and quantum-level processes).

Future studies will use advanced functional imaging technologies to examine the role of complex nonlinear dynamic relationships between neural circuits and the immune system and specific psychiatric disorders. These new technologies will be used to examine the postulated role of quantum “entanglement” associated with large-scale coherent macroscopic quantum field effects in both normal consciousness functioning and psychiatric symptom formation.

Ongoing advances in the neurosciences, psychopharmacology, and brain imaging research will soon yield novel assessment approaches and more effective and safer conventional treatments. Drugs based on novel mechanisms of action and new therapeutic uses of light, weak electrical current, and magnetic fields will provide new treatment modalities. Collectively, these advances will transform the theoretical foundations and clinical therapeutics of contemporary Western mental health care.

A revolution in psychiatric treatment

Novel theories in biomedical psychiatry promise significant advances in understanding the nature and causes of mental illness. For example, nonlinear dynamics (ie, chaos theory) may help explain the complex influences of hormones and neurotransmitters on mood changes during the menstrual cycle as well as social and psychological variables on mood.1 Substantiation of this model by research findings may eventually lead to effective preventive strategies that address hormone-mediated mood disturbances. There is significant emerging evidence that complex interactions between immune function, neurotransmitters, and hormones are important in depressed mood, anxiety, and other mental disorders.2

Improved understanding of genetic factors that mediate mental illness continues to accrue from analysis of the data from the Human Genome Project. Biomedical psychiatric research is increasingly taking into account the significance of genetic and biochemical variability in mental illness. For example, the high degree of individual variability in response to conventional drugs suggests poorly characterized differences in neurotransmitter deficiencies or imbalances associated with MDD, generalized anxiety disorder, and other psychiatric disorders.3

Studies on the effects of neurotransmitter depletion on mood are consistent with the view that changes in brain serotonin or norepinephrine activity levels alone do not fully explain the causes of depressed mood or observed differential responses to antidepressants. These differences are probably related to complex biological and social factors, such as genetic variability (and thus, ethnicity), diet, and culturally determined expectations.

Genetic, cultural, and social variability translates into differences in effective dosing strategies using conventional drugs and commensurate differences in susceptibility to adverse effects.4 The high degree of biological variability may be especially problematic for African or Asian patients and might cause safety issues or poor outcomes.5,6

The AmpliChip CYP450 test, recently introduced by Roche Pharmaceuticals, incorporates 2 DNA amplification and detection technologies that screen for genetic mutations. A polymerase chain reaction is used to amplify or make copies of genetic material followed by high-density microarray technology to capture and scan the amplified DNA. The device will enable physicians to determine when variations or mutations are present in the cytochrome P-450 (CYP450) system. The device provides information about individual differences in prescription drug metabolism. Psychiatrists will be able to routinely order outpatient laboratory tests to determine the most appropriate drugs and dosages for a given patient while minimizing the risk of adverse effects.7

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