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Individualized preventive psychiatry: syndrome and vulnerability diagnostics

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Abstract

The development of prevention and treatment strategies of psychiatric disorders will depend on a more profound knowledge of the complex relationships between gene-environment interactions, particularly the interplay of vulnerability and resilience factors within a person’s biography. In this article, the advantages and limitations of the current psychiatric classification systems will be discussed. New directions for a future multiaxial system including biological, psychological, social, life span, gender and cultural factors based on the DSM-V- and ICD-11-research agenda are going to be outlined. Psychiatry without psychopathology is impossible. However, in the future, psychopathology will be closer linked to the biological and psychological nature of the disease process and more function-based. Future diagnostic classification manuals should include dimensional and categorical aspects as well as vulnerability and resilience diagnostic elements. There is a need for a personalized integrative diagnosis and care.

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References

  1. Almeida D (2005) Resilience and vulnerability to daily stressors assessed via dairy methods. Curr Dir Psychol Sci 14:64–68

    Article  Google Scholar 

  2. Altemus M (2007) Neurobiology and sex/gender. In: Narrow W, First M, Sirovatka P, Regier D (eds) Age and gender considerations in psychiatric diagnosis. Am Psychiatric Association, Arlington, pp 47–63

    Google Scholar 

  3. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn, DSM-IV-TM. Am Psychiatric Association, Washington, pp XV–XXV

  4. Angst J (2007) The bipolar spectrum. Br J Psychiatry 190:189–191

    Article  PubMed  Google Scholar 

  5. Antonovsky A (1996) The salutogenic model as a theory to guide health promotion. Health Promot Int 11:453–470

    Article  Google Scholar 

  6. Bennett AJ (2008) Gene environment interplay: nonhuman primate models in the study of resilience and vulnerability. Dev Psychobiol 50:48–59

    Article  PubMed  Google Scholar 

  7. Canli T, Lesch K (2007) Long story short: the serotonin transporter in emotion regulation and social cognition. Nat Neurosci 10:1103–1109

    Article  PubMed  CAS  Google Scholar 

  8. Charney D, Barlow D, Botteron K et al (2002) Neuroscience research agenda to guide development of a pathophysiologically based classification system. In: Kupfer D, First M, Regier D (eds) Research agenda for DSM-V. American Psychiatric Association, Washington, pp 31–83

    Google Scholar 

  9. Cicchetti D, Blender JA (2006) A multiple-levels-of-analysis perspective on resilience: implications for the developing brain, neural plasticity and preventive interventions. Ann NY Acad Sci 1094:248–258

    Article  PubMed  Google Scholar 

  10. Daud A, Skoglund E, Rydelins P (2005) Children in families of torture victims. Transgenerational transmission of parents traumatic experiences to their children. Int J Soc Welfare 14:23–32

    Article  Google Scholar 

  11. Daud A, Klinteberg B, Rydelius P (2008) Resilience and vulnerability among refugee children of traumatized and non-traumatized parents. Child Adolesc Psychiatr Mental Health 2:7. doi:10.1186/1753-2000-2-7

    Article  Google Scholar 

  12. De Quervain D, Kolassa I, Ertl V, Onyut P, Neuner F, Elbert T, Papassotiropoulos A (2007) A deletion variant of the α2b-adrenoceptor is related to emotional memory in Europeans and Africans. Nat Neurosci. doi: 10.1038/nn 1945

  13. De Rosse P, Funke B, Burdick K, Lencz T, Ekholm J, Kane J, Kucherlapati R, Malhotra A (2006) Dysbindin genotype and negative symptoms in schizophrenia. Am J Psychiatry 163:532–534

    Article  Google Scholar 

  14. Gaebel W, Wölwer W, Zielasek J (2006) Von der deskriptiven zur funktionalen Psychopathologie: Auf dem Weg zu einer modularen Psychiatrie. Die Psychiatrie 3:221–232

    Google Scholar 

  15. Garmezy N, Masten A, Tellegen A (1984) The study of stress and competence in children: a building block for developmental psychopathology. Child Dev 55:97–111

    Article  PubMed  CAS  Google Scholar 

  16. Gotlib I, Joormann J, Minor K, Hallmayer J (2008) HPA axis reactivity: a mechanism underlying the associations among 5-HTTLPR, stress and depression. Biol Psychiatry 63:847–851

    Article  PubMed  CAS  Google Scholar 

  17. Grant B, Weissmann M (2007) Gender and the prevalence of psychiatric disorders. In: Narrow W, First M, Sirovatka P, Regier D (eds) Age and gender considerations in psychiatric diagnosis. Am Psychiatric Association, Arlington, pp 31–45

    Google Scholar 

  18. Greenwood T and the consortium on the genetics of schizophrenia (2007) Initial heritability analyses of endophenotypic measures of schizophrenia. Arch Gen Psychiatry 64 (11): 1242–1250

    Google Scholar 

  19. Heim C, Newport D, Heit S, Graham Y, Wilcox M, Bonsall R, Miller A, Nemeroff C (2000) Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. JAMA 284:592–597

    Article  PubMed  CAS  Google Scholar 

  20. Kendell R, Jablensky A (2003) Distinguishing between the validity and utility of psychiatric diagnoses. Am J Psychiatry 160:4–12

    Article  PubMed  Google Scholar 

  21. Kim J (2008) Serotonin, stress and conditioning. Biol Psychiatry 63:819–820

    Article  PubMed  Google Scholar 

  22. Klaassens E, van Veen T, Zitman F (2008) Does trauma cause lasting changes in HPA-axis functioning in healthy individuals. Prog Brain Res 167:273–275

    Article  PubMed  Google Scholar 

  23. Kobassa SC (1979) Stressful life events, personality and health: an inquiry into hardiness. J Pers Soc Psychol 37(1):1–11

    Article  Google Scholar 

  24. McEwen B (2006) Protective and damaging effects of stress mediators: central role of the brain. Dialogues Clin Neurosci 8:367–381

    PubMed  Google Scholar 

  25. Mezzich J, Salloum I (2008) Clinical complexity and person-centered integrative diagnosis. World Psychiatry 7:1–2

    PubMed  Google Scholar 

  26. Mössner R, Mikova O, Koutsilieri E, Saoud M, Ehlis A, Müller N, Fallgatter A, Riederer P (2007) Consensus paper of the WFSBP task force on biological markers: biological markers in depression. World J Biol Psychiatry 8:141–174

    Article  PubMed  Google Scholar 

  27. Moore S, Zoellner L (2007) Overgeneral autobiographical memory and traumatic events: an evaluative review. Psychol Bull 133:419–437

    Article  PubMed  Google Scholar 

  28. Munafo M, Brown S, Hariri A (2008) Serotonin transporter (5-HTTLPR) genotype and amygdala activation: a meta-analysis. Biol Psychiatry 63:852–857

    Article  PubMed  CAS  Google Scholar 

  29. Olff M, de Vries G, Güzelcan Y, Assies J, Gersons B (2007) Changes in cortisol and DHEA levels after psychotherapy for PTSD. Psychoneuroendocrinology 32:619–626

    Article  PubMed  CAS  Google Scholar 

  30. Otto M, Henin A, Hirshfeld-Becker D, Pollack M, Biedermann J, Rosenbaum J (2007) Posttraumatic stress disorder symptoms following media exposure to tragic events: impact of 9/11 on children at risk for anxiety disorders. J Anxiety Disord 21:888–902

    Article  PubMed  Google Scholar 

  31. Pesonen A, Räikkönen K, Heinonen K, Andersson S, Hovi P, Järvenpää A, Eriksson J, Kajantie E (2008) Personality of young adults born prematurely: the Helsinki study of very low birth weight adults. J Child Psychol Psychiatry 49(6):609–617

    Article  PubMed  Google Scholar 

  32. Regier D, Sirovatka P, Rubio-Stipec M, Narrow W (2007) The future of psychiatric diagnosis: the APA/WHO/NIH research planning process for DSM and ICD. Die Psychiatrie 4:98–104

    Google Scholar 

  33. Rounsaville B, Alarcón R, Andrews G, Jackson J, Kendell R, Kendler K (2002) Basic nomenclature issues for DSM-V. In: Kupfer D, First M, Regier D (eds) Research agenda for DSM-V. American Psychiatric Association, Washington, pp 1–29

    Google Scholar 

  34. Rutter M, Pickles A, Murray R, Eaves L (2001) Testing hypotheses on specific environmental causal effects on behavior. Psychol Bull 127:291–324

    Article  PubMed  CAS  Google Scholar 

  35. Silver R, Kanichay R (2008) Neuroscience: refreshing connections. Science 320:183–184

    Article  PubMed  CAS  Google Scholar 

  36. Singer W (2005) How does the brain know when it is right? In: Changeux J, Damasio A, Singer W (eds) Neurobiology of human values. Springer Publ, Berlin, pp 125–135

    Chapter  Google Scholar 

  37. Smoller J, Paulus M, Fagerness J, Purcell S, Yamaki L, Hirshfeld-Becker D, Biederman J, Rosenbaum J, Gelernter J, Stein M (2008) Influence of RGS2 on anxiety-related temperament, personality and brain function. Arch Gen Psychiatry 65(3):298–308

    Article  PubMed  CAS  Google Scholar 

  38. Stawski R, Sliwinski M, Almeida D, Smyth J (2008) Reported exposure and emotional reactivity to daily stressors: the roles of adult age and global perceived stress. Psychol Aging 23(1):52–61

    Article  PubMed  Google Scholar 

  39. Sterling P, Eyer J (1988) Allostasis: a new paradigm to explain arousal pathology. In: Fisher S, Reason J (eds) Handbook of life stress, cognition and health. Wiley, New York, pp 629–649

    Google Scholar 

  40. Tsankova N, Renthal W, Kumar A, Nestler E (2007) Epigenetic regulation in psychiatric disorders. Nat Neurosci 8:355–367

    CAS  Google Scholar 

  41. Van den Bergh B, van Calster B, Smits T van Huffel S, Lagae L (2007) Antenatal maternal anxiety is related to HPA-axis dysregulation and self-reported depressive symptoms in adolescence, a prospective study on the fetal origins of depressed mood. Neuropsychopharmacology: 1–10

  42. Yehuda R, Teicher M, Seckl J, Grossmann R, Morris A, Bierer L (2007) Parental posttraumatic stress disorder as a vulnerability factor for low cortisol trait in offspring of Holocaust survivors. Arch Gen Psychiatry 64:1040–1048

    Article  PubMed  CAS  Google Scholar 

  43. Zobel A, Meier W (2004) Endophenotypes: a new concept for the biological characterization of mental disorders. Nervenarzt 75:205–214

    Article  PubMed  CAS  Google Scholar 

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The author has no conflict of interest with any commercial or other associations in connection with the submitted article.

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  1. Ärztlicher Direktor, Wilhelm Klein-Strasse 27, 4025, Basel, Switzerland

    Franz Müller-Spahn

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  1. Franz Müller-Spahn
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Correspondence to Franz Müller-Spahn.

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Müller-Spahn, F. Individualized preventive psychiatry: syndrome and vulnerability diagnostics. Eur Arch Psychiatry Clin Neurosci 258 (Suppl 5), 92–97 (2008). https://doi.org/10.1007/s00406-008-5020-4

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