{"id":57403,"date":"2015-06-01T18:40:54","date_gmt":"2015-06-01T22:40:54","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=57403"},"modified":"2015-06-02T15:04:40","modified_gmt":"2015-06-02T19:04:40","slug":"the-talk-that-matters","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2015\/06\/01\/the-talk-that-matters\/","title":{"rendered":"the talk that matters…"},"content":{"rendered":"
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Training for the Future<\/a><\/div>\n
NIMH: Director’s Blog<\/font><\/strong><\/div>\n
by Tom Insel<\/div>\n
May 15, 2015<\/div>\n

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…It’s true that most of the neuroscience and genomics findings are not yet actionable for psychiatry<\/font><\/strong><\/em>. No one doubts that the brain is the organ of affect and behavior, but no one can point to a biomarker that is essential for clinical practice. In the short-run, we may do much more to bend the curve on suicide mortality by changing public policy [such as through restricting access to means] rather than finding a biomarker for suicidality<\/font><\/strong><\/em>. But in the long-run, and we need a long-run strategy, policy will hit a wall and we will need better diagnostics and therapeutics. That is where this new initiative can make a difference. The research of 2015 suggests that the clinician of 2025 and certainly the clinician of 2035 will need to know about cortical dynamics, neural networks, and genomic variation. Those entering the field today will need to know how to think about the brain and how to critique brain science. By changing the training of the next generation, we not only prepare for the future, we create it.<\/font><\/strong><\/em><\/div>\n<\/blockquote>\n\n\n
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Genomic Biomarker for Suicidality Found!<\/font><\/strong> <\/p>\n
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Independent Georgia researcher, 1boringoldman, working closely with the CDCwebsite<\/sub> discovers clear evidence of…<\/font><\/strong> <\/div>\n<\/td>\n<\/tr>\n<\/table>\n
[No, I haven’t gotten any calls from the Karolinska Institutet<\/font> in Stockholm yet, but hope springs eternal. Should I perhaps add waiting room screening for the Y Chromosome?].<\/sup><\/div>\n

As an Internist, I never heard the term "biomarkers" or any of its synonyms. And yet they were part of everyday medical life. They were the tests we ordered to make or confirm diagnoses; the parameters we followed to monitor treatment; and the screening tests we collected to detect risk or early signs of disease. In Psychiatry, there weren’t any. Biomarkers were the thing that we didn’t have. Actually, by the time I showed up, we did have a couple in Melancholic Depression<\/font>, Dr. Carroll’s Dexamethasone Suppression Test<\/font> and Dr. Kupfer’s REM Sleep Latency<\/font> studies. As is often also the case in physical medicine, neither was pathognomonic. But they stacked up well against many of our medical colleagues’ biological tests – particularly in combination. Then, in the most peculiar of moves, we discarded the diagnosis they marked<\/font><\/em> [Melancholic Depression<\/font>], and that was that for our brief biomarker years [until, of course, my recent breakthrough above!]. So we rely on the more subjective rating scales like the HAM-D<\/a> or the PANSS<\/a>.<\/p>\n

Psychiatry’s greatest internal critic, Thomas Szasz<\/font>, actually fueled the modern psychiatric obsession with biomarkers. Szasz argued that Mental Illness was a false construct – a Myth.<\/div>\n