THE FUTURE OF PSYCHIATRY
The Medici effect encapsulates the benefits of cross-pollination and interaction between individuals and teams from different fields in the pursuit of innovation. It is named after the wealthy Medici family who helped catalyze the Renaissance by bringing together poets, philosophers, scientists, painters, and other artisans to Florence, Italy. We believe the modern Medici effect is convergence science, and it is set to revolutionize health and medicine in the 21st century given the interplays occurring among physical, computer, and life sciences.
Convergence science is defined as the merging of distinct technologies, industries, tools, disciplines, or devices into a unified whole to create new pathways and opportunities. Convergence relies on a new integrated approach to solving problems too complex for any single discipline. Sharp and Langer1 described convergence as the “third revolution” in biomedicine after the development of molecular and cellular biology (the first revolution) and genomics (the second revolution). Based on a study of scientific progress at the Massachusetts Institute of Technology, convergence science was recommended as a way to blend diverse scientific disciplines. More than an interdisciplinary science, convergence integrates distant paradigms, systems, theories, and disciplines with problem-oriented research that crosses boundaries of academic, public, and private spheres.
Learning from oncology
Oncology may be the current biomedical frontier for convergence science. Indeed, a new academic journal has just been launched: Convergent Science Physical Oncology.2 The aim of the journal is to integrate physical science with cancer biology and clinical oncology to advance the understanding and treatment of cancer in patients. The National Cancer Institute’s Center for Strategic Scientific Initiatives supports convergent approaches to cancer innovation. Their mission is to “create and implement exploratory programs focused on the development and integration of advanced technologies, transdisciplinary approaches, infrastructures, and standards to accelerate the creation of publically available, broadly accessible, multidimensional data, knowledge, and tools to empower the entire cancer research continuum for patient benefits.”
This initiative has led to Cancer Nanotechnology Excellence and Integrative Cancer Biology Program Centers to be constructed to support convergent projects. Private companies (eg, IBM and NantHealth) are already developing data intensive systems to integrate, display, and analyze—via machine learning—data from all health providers, genomic and proteomic analyses, imaging, and other medical devices, with the actionable health information available at the point of care, anywhere.
Initiatives supporting convergence science approaches for psychiatry
If convergence is an approach to complexity, then what appears promising for oncology should be even more useful for psychiatry. Indeed, this approach has already been harnessed for neuroscience. A number of large-scale convergence neuroscience initiatives are underway globally, and these initiatives are essential to making progress in neuroscience. These projects bring together researchers from a multitude of disciplines to understand the basic functioning of the human brain, and the dysfunction that occurs during illness.
One such initiative is the Brain Research Through Advancing Innovative Neurotechnologies (BRAIN) initiative funded by public agencies, private companies, and foundations.3 The express aim of this initiative is to develop new tools and technologies that will enable the research community to obtain a dynamic picture of the brain in action. With nearly 100 billion cells making 100 trillion connections, this is no small aim and will simply not be achievable with current tools and disciplinary approaches. One of the express themes of action for the BRAIN initiative is to “cross boundaries in interdisciplinary collaborations.” The BRAIN initiative consists of teams of engineers, nanotechnologists, computational scientists, materials scientists, and neuroscientists to create the next generation of imaging tools or probes for brain activity.
Will convergence become the future of psychiatry?
Arguably, if the brain is so complex as to require a convergent approach, then the study of psychiatry (mind, brain, and behavior) is complexity on a whole different level. Although the challenge is evident, our approaches have been remarkably singular, focusing on the mind, the brain, or behavior in isolation, with too little integration across disciplines and even less assistance from the vast areas of science that are now poised to alter other areas of medicine.
Dr Eyre is a PhD student within the discipline of psychiatry at the University of Adelaide in Adelaide, Australia; Dr Lavretsky is Professor in Residence in the department of psychiatry at the Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA; Dr Insel is Director of the National Institute of Mental Health, Bethesda, MD. The authors report no conflicts concerning the subject matter of this article.
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