Monday, September 9, 2013

Nobel Laureate Comments on Biology of Psychiatric Disorders

In an op-ed essay that appeared in the May 28 New York Times, David Brooks claimed that psychiatry is not really a science, but a semi-science. This claim prompted Eric Kandel, M.D., to respond in his own op-ed essay, which appeared in the September 6 New York Times. In addition to being a professor at Columbia University, Kandel was a recipient of the 2000 Nobel Prize in Physiology or Medicine.

"The reason that Mr. Brooks is understandably conflicted about seeing psychiatry as a medical discipline is that we do not understand the biological substratum of most psychiatric disorders, and certainly we are nowhere near understanding them as well as we understand disorders of the liver or the heart," Kandel told Psychiatric News. "But the fact is that we are beginning to make some progress, and although it is slow, it is accelerating. I wrote the New York Times response to give the reader a few examples of that."

For example, "We are beginning to discern the outlines of a complex neural circuit that becomes disordered in depressive illnesses," he wrote. "Helen Mayberg, at Emory University, and other scientists used brain-scanning techniques to identify several components of this circuit, two of which are particularly important." They are the subcallosal cingulate region, "which mediates our unconscious and motor responses to emotional stress," and the right anterior insula, "a region where self-awareness and interpersonal experience come together."

Moreover, he wrote, "ANY discussion of the biological basis of psychiatric disorders must include genetics. Most mutations produce small differences in our genes, but scientists have recently discovered that some mutations give rise to structural differences in our chromosomes. Such differences are known as copy number variations....Matthew State, at the University of California, San Francisco, has discovered a remarkable copy number variation involving chromosome 7. An extra copy of a particular segment of this chromosome greatly increases the risk of autism, which is characterized by social isolation. Yet the loss of that same segment results in Williams syndrome, a disorder characterized by intense sociability."

Click here for Kandel's New York Times essay, "The New Science of Mind."


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