Psychiatry at Mayo Clinic and throughout the world is entering a new and exciting era of discovery. The field has moved well beyond the description of psychiatric symptoms to an exploration of the underlying neurophysiological processes that control mood and cognition.
When the environment or medical conditions interfere with the nervous system, people can develop signs and symptoms of mental illness.
A new era of technology
Two new powerful tools have been developed to facilitate psychiatric research.
Mircroarray genomic DNA analysis
The first new tool is microarray genomic DNA analysis. Using this technology, the genetic individuality of patients with depression and anxiety disorders can be defined. This technique allows investigators to define the influence of informative changes known as polymorphisms in the structure of genes. Beyond determining individual genomic variation, this new methodology for studying gene products provides a novel strategy for the development of new psychotropic agents. In addition to the immediate practical implications of being able to provide personalized therapy based on pharmacogenomic information, the basic diagnostic taxonomy of psychiatric disorders is undergoing a major conceptual revision based on this variation.
MR brain imaging
The second major tool is the development of our ability to visualize the brain. It is now possible to identify very small variation in the structure of the brain using new enhancements of magnetic resonance imaging (MRI). Even more importantly, we are developing neuroimaging techniques that demonstrate variation in function of individual brain regions. At Mayo Clinic, we are employing magnetic resonance spectroscopy (MRS) to explore the underlying neural mechanisms that are responsible for both abnormal function and therapeutic change.
At the bedrock of our understanding of psychopathology has been our ability to establish the contextual meaning of the psychiatric symptoms experienced by each patient. The development of a strong therapeutic relationship continues to be recognized as a critical component of psychiatric treatment. However, beyond the establishment of an empathic interpersonal context, we have developed a hierarchy of therapeutic modalities for the treatments that are now being studied within the department. These include genomically informed psychopharmacological trials, pilot studies of transcranial magnetic stimulation, and well-developed clinical trials studying the optimal application of electroconvulsive therapy in treatment resistant depressed patients.