The Relationship Between Reductionism and Prediction in Psychiatry: A Survey

Introduction. Biological psychiatry has yet to find clinically useful biomarkers despite mucheffort. Is this because the field needs better methods and more data, or are current conceptualizations of mental disorders too reductionistic? Although this is an important question, there seems to be no consensus on what it means to be a “reductionist”. Aims. This paper aims to; a) to clarify the views of researchers on different types of reductionism; b) to examine the relationship between these views and the degree to which researchers believe mental disorders can be predicted from biomarkers; c) to compare these predictability estimates with the performance of machine learning models that have used biomarkers to distinguish cases from controls. Methods. We created a survey on reductionism and the predictability of mental disorders from biomarkers, and shared it with researchers in biological psychiatry. Furthermore, a literature review was conducted on the performance of machine learning models in predicting mental disorders from biomarkers. Results. The survey results showed that 9% of the sample were dualists and 57% were explanatory reductionists. There was no relationship between reductionism and perceived predictability. The estimated predictability of 11 mental disorders using currently available methods ranged between 65-80%, which was comparable to the results from the literature review. However, the participants were highly optimistic about the ability of future methods in distinguishing cases from controls. Moreover, although behavioral data were rated as the most effective data type in predicting mental disorders, the participants expected biomarkers to play a significant role in not just predicting, but also defining mental disorders in the future.

XVII Congress of Russian Psychiatrists (Together with Regional Congress of World Psychiatric Association) “Interdisciplinary Approach to Comorbidity of Mental Disorders on the Way to Integrative Treatment”, 2021 May 15–18, Saint Petersburg

The aim of the paper was to provide an overview of the reports presented at the congress on the main problems of clinical and biological psychiatry. Discussion and conclusion: A representative forum of domestic psychiatrists and narcologists, psychotherapists and psychologists, organizers of psychiatric care and the leading scientists in the fi eld of clinical and biological psychiatry was held together with the Regional Congress of the World Psychiatric Association (WPA). The thematic diversity of the reports corresponded to the main problem, refl ected in the title of the congress. The opportunity to review and discuss achievements in scientifi c and practical activities of colleagues and to present their own data was the basis for summing up and identifying the prospects for protecting the mental health of the population at the current level of knowledge and using effective technologies.

Critical Period Plasticity as a Framework for Psychedelic-Assisted Psychotherapy

As psychedelic compounds gain traction in psychiatry, there is a need to consider the active mechanism to explain the effect observed in randomized clinical trials. Traditionally, biological psychiatry has asked how compounds affect the causal pathways of illness to reduce symptoms and therefore focus on analysis of the pharmacologic properties. In psychedelic-assisted psychotherapy (PAP), there is debate about whether ingestion of the psychedelic alone is thought to be responsible for the clinical outcome. A question arises how the medication and psychotherapeutic intervention together might lead to neurobiological changes that underlie recovery from illness such as post-traumatic stress disorder (PTSD). This paper offers a framework for investigating the neurobiological basis of PAP by extrapolating from models used to explain how a pharmacologic intervention might create an optimal brain state during which environmental input has enduring effects. Specifically, there are developmental “critical” periods (CP) with exquisite sensitivity to environmental input; the biological characteristics are largely unknown. We discuss a hypothesis that psychedelics may remove the brakes on adult neuroplasticity, inducing a state similar to that of neurodevelopment. In the visual system, progress has been made both in identifying the biological conditions which distinguishes the CP and in manipulating the active ingredients with the idea that we might pharmacologically reopen a critical period in adulthood. We highlight ocular dominance plasticity (ODP) in the visual system as a model for characterizing CP in limbic systems relevant to psychiatry. A CP framework may help to integrate the neuroscientific inquiry with the influence of the environment both in development and in PAP.