Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-20T03:32:18.180Z Has data issue: false hasContentIssue false

Symptoms are not the solution but the problem: Why psychiatric research should focus on processes rather than symptoms

Published online by Cambridge University Press:  06 March 2019

Immanuel G. Elbau
Affiliation:
Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany. [email protected]@[email protected]://www.psych.mpg.de/1448291/binder
Elisabeth B. Binder
Affiliation:
Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany. [email protected]@[email protected]://www.psych.mpg.de/1448291/binder
Victor I. Spoormaker
Affiliation:
Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany. [email protected]@[email protected]://www.psych.mpg.de/1448291/binder

Abstract

Progress in psychiatric research has been hindered by the use of artificial disease categories to map distinct biological substrates. Efforts to overcome this obstacle have led to the misconception that relevant psychiatric dimensions are not biologically reducible. Consequently, the return to phenomenology is once again advocated. We propose a process-centered paradigm of biological reduction compatible with non-reductive materialism.

Type
Open Peer Commentary
Copyright
Copyright © Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Friston, K. (2010) The free-energy principle: A unified brain theory? Nature Reviews Neuroscience 11(2):127–38. doi:10.1038/nrn2787.Google Scholar
Friston, K. J., Redish, A. D. & Gordon, J. A. (2017) Computational nosology and precision psychiatry. Computational Psychiatry 1(1):223.Google Scholar
Granger, H. J. (1998) Cardiovascular physiology in the twentieth century: Great strides and missed opportunities. The American Journal of Physiology 275(6, Pt 2):H192536.Google Scholar
Insel, T. R., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., Sanislow, C. & Wang, P. (2010) Research domain criteria (RDoC): Toward a new classification framework for research on mental disorders. The American Journal of Psychiatry 167(7):748–51. doi:10.1176/appi.ajp.2010.09091379.Google Scholar
Katahira, K. & Yamashita, Y. (2017) A theoretical framework for evaluating psychiatric research strategies. Computational Psychiatry 1(1):184207.Google Scholar
Keiflin, R. & Janak, P. H. (2015) Dopamine prediction errors in reward learning and addiction: From theory to neural circuitry. Neuron 88(2):247–63. doi:10.1016/j.neuron.2015.08.037.Google Scholar
Kotchen, T. A. (2011) Historical trends and milestones in hypertension research: A model of the process of translational research. Hypertension 58(4):522–38. doi:10.1161/HYPERTENSIONAHA.111.177766.Google Scholar
Lenfant, C. (2010) Chest pain of cardiac and noncardiac origin. Metabolism 59(Suppl. 1):S41S46. doi:10.1016/j.metabol.2010.07.014.Google Scholar
Peters, A., McEwen, B. S. & Friston, K. (2017) Uncertainty and stress: Why it causes diseases and how it is mastered by the brain. Progress in Neurobiology 156:164–88.Google Scholar
Schumann, G., Binder, E. B., Holte, A., de Kloet, E. R., Oedegaard, K. J., Robbins, T. W., Walker-Tilley, T. R., Bitter, I., Brown, V. J., Buitelaar, J., Ciccocioppo, R., Cools, R., Escera, C., Fleischhacker, W., Flor, H., Frith, C. D., Heinz, A., Johnsen, E., Kirschbaum, C., Klingberg, T., Lesch, K. P., Lewis, S., Maier, W., Mann, K., Martinot, J. L., Meyer-Lindenberg, A., Müller, C. P., Müller, W. E., Nutt, D. J., Persico, A., Perugi, G., Pessiglione, M., Preuss, U. W., Roiser, J. P., Rossini, P. M., Rybakowski, J. K., Sandi, C., Stephan, K. E., Undurraga, J., Vieta, E., van der Wee, N., Wykes, T., Haro, J. M. & Wittchen, H. U. (2014) Stratified medicine for mental disorders. European Neuropsychopharmacology 24(1):550. doi:10.1016/j.euroneuro.2013.09.010.Google Scholar
Stephan, K. E., Manjaly, Z. M., Mathys, C. D., Weber, L. A. E., Paliwal, S., Gard, T., Tittgemeyer, M., Fleming, S. M., Haker, H., Seth, A. K. & Petzschner, F. H. (2016) Allostatic self-efficacy: A metacognitive theory of dyshomeostasis-induced fatigue and depression. Frontiers in Human Neuroscience 10. doi:10.3389/fnhum.2016.00550. Online article, available at: https://www.frontiersin.org/articles/10.3389/fnhum.2016.00550/full.Google Scholar
Zachar, P. & Kendler, K. S. (2017) The philosophy of nosology. Annual Review of Clinical Psychology 13:4971. doi:10.1080/09608789908571020.Google Scholar