How Precise Is Precision Medicine for Schizophrenia?

Lynn E. DeLisi; W. Wolfgang Fleischhacker

Disclosures

Curr Opin Psychiatry. 2016;29(3):187-189. 

In This Article

Introduction

In the years we have been compiling these annual reviews on the latest issues discussed about schizophrenia, various publicized buzz words have come and gone. This year the most popular term seems to be 'precision medicine',[1] that is, individualizing treatment of patients suffering from heterogeneous disorders, such as cancer, obesity, and neurological disorders, employing different biological markers that can serve as targets for specific medicines. Precision medicine is the belief that 'one medication' is not likely to help all, despite treatment trials that show it is effective in patient groups as a whole. The field of 'precision medicine' could also be broadened to include prediction of future illness and of outcome over the course of the disease. Practicing precision medicine would allow us to make use of the ever advancing fields of genetics and brain imaging to develop markers for therapeutic targets and to treat patients individually based on specific targets rather than ill-defined disease entities. US President Obama, in early January of 2015, announced The National Institutes of Health Precision Medicine Initiative.[2] This would strengthen efforts to use 'big data' (very large datasets) for extrapolating to individualized care in the clinic and to develop methods to ensure reproducibility of such data.[3] Reaching the ultimate goals of precision medicine will also require discussions of the ethical issues involved in integrating and sharing big data from populations of study participants.[4,5] There is even a new journal for peer review publications on this topic named the Journal of Precision Medicine, which has free Internet access. Publications on the use of the principles of precision medicine in neuropsychiatry are already available,[6,7] also focusing on schizophrenia.[8] They describe the need to focus on determining the level of risk, on the early pathophysiological mechanisms responsible for illness, and their combination with patient-specific molecular underpinnings of the disease, the goal being to provide personalized and individually centered treatments.

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