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Rethinking Mental Disorders SUMMER 2011 encounters Newsletter of the European Molecular Biology Organization Rethinking mental disorders Nikolas Rose from the BIOS Centre at the London School of the world – suggests that 25 per cent of adults not currently receiving Economics talks about how a mental disorder is defi ned, how psychiatric treatment could be diagnosed for mental disorders at any psychiatry is infl uenced by neurosciences and the controversial time; and the WHO predicts that by the year 2020 depression will be revision of the manual of psychiatric diagnosis. Rose is keynote one of the leading causes of ill health. speaker at Making sense of mental illness: biology, medicine and society, the EMBO | EMBL Science & Society Conference to be held What caused such an explosion? in Heidelberg from 4–5 November. This is a matter of dispute. Is there genuinely so much mental ill health? Are the fi gures a result of fl awed research methods? Are they a Nikolas, how big is the impact of mental health issues on consequence of increased recognition fuelled by awareness campaigns, today’s society? some funded by those that stand to gain? Or does this have something There is an increasing belief among professionals and lay persons to do with the diagnostic procedures themselves? Even minor mental that many troubles of everyday life, as well as more serious problems, troubles now come within the scope of psychiatric diagnostic manu- result from mental disorders. Policy makers are particularly concerned als. The American Psychiatric Association – currently revising the that mental illness not only produces distress for individuals and their Diagnostic and Statistical Manual of Mental Disorders (see info box) families, but also leads to the loss of many working days and is costly – is coming to the view that one should move away from categorical for social and health services. distinctions to a dimensional approach. Some say that this might lead to even more people being ‘suitable cases for treatment’. Why do you think this topic has recently received so much attention? Partly this is a result of awareness campaigns by many organizations; If such a huge percentage of the HIGHLIGHTS and partly because increasingly people are willing to speak out about population is affected then perhaps their experience of mental ill health. There is also the growing aware- this is simply an inherent part of ness of the problems of dementia due to an aging population. Also, our lives. Interview with almost all of us have experienced our parents, relatives or close friends Many do make that argument, and Carol V. Robinson – suffering from mild, moderate or even severe psychiatric conditions. this is one of the interesting areas of 2011 FEBS | EMBO Women 5 our conference. In my introductory in Science Award winner Can we speak of a global epidemic of mental disorder? talk I’ll try to explain the dilemma: The statistics certainly paint an alarming picture. The epidemiology (continued on next page) ➞ ➞ both in the US and in Europe – the wealthiest and healthiest regions of Things to do in Vienna – polling the local EMBO community 7/8 INFO BOX | Revision of psychiatric diagnostic manual First published in 1952, the law breakers may be confi ned in additions to the fi fth edition – Diagnostic and Statistical Manual psychiatric institutions instead of the fi rst complete revision since Ice and anther – of Mental Disorders (DSM) is at the being imprisoned and how much 1994 – will lead to an increase in best of The EMBO Journal heart of mental health research, insurance companies pay for the number of people being diag- cover contest 9 planning, policy and treatment treatment. Over the last decades, nosed with mental disorders and in the US and in varying degrees more mental disorders have treated, sometimes with unneces- around the world. It is a power- been included in the manual, sary drugs that have troublesome Biocenter Finland – ful tool that determines who gets although some have also been side effects. The new edition is developing cost-effi cient diagnosed as mentally ill, who removed, most notably homosex- due out in May 2013. services at the national receives what kind of drugs, which uality. Critics say that proposed 11 level EMBO | Meyerhofstr. 1 | 69117 Heidelberg | Germany | T +49 6221 8891 0 | [email protected] www.embo.org 2 Rethinking mental disorders (cont.) Interview with Nikolas Rose where should one draw the the advances at the neurobio- boundaries between a condi- logical level and our capacity to tion that is appropriate for intervene therapeutically in the diagnosis and treatment clinic. And as for diagnosis, it and a condition that is part remains the case that there are of everyday life that people no generally accepted and vali- need to accept? Where does dated biomarkers for any psychi- childhood bad behavior end atric condition that can be used and ADHD begin? Normal clinically. sadness end and depression begin? Age-related memory Which fi eld of neuroscience do loss end and Mild Cognitive you think will receive particular Impairment begin? Many indi- attention in the coming years? vidual and social consequenc- 12th joint One major issue – not just in EMBO | EMBL conference es fl ow from the way we draw on Science & Society advanced industrial societies these lines. 4 – 5 November 2011 but also in countries such as EMBL Advanced Training Centre | Heidelberg | Germany China or India – is the question Which therapies for mental Speakers, chairs, of dementia and Alzheimer’s disorder have made the biggest & panellists: disease. Obviously as the popu- Friday | 4 November Dusan Bartsch DE progress in the last decades? Nikolas Rose lation ages, the incidence of I think one can detect a grow- Keynote speaker Mathias Berger DE these disorders increases. The Donna Franceschild UK ing disenchantment with Topics extent to which we are able to Impact and defi nition of Cornelius Gross IT psychopharmaceuticals as the mental illness Tim Kendall UK characterize these disorders at universal therapy of choice. The biology of mental David J. Kupfer US a neurobiological level in living illness In the eighties and nineties Simon Lovestone UK individuals – that is to differen- many people began to argue Saturday | 5 November Helen S. Mayberg US tiate between early Alzheimer’s Topics Andreas Meyer-Lindenberg DE that depressive conditions STUDENTS and normal aging – is a matter 04.11.2011 20 Euro Pills, sofas and surgery – Geraint Rees UK 1 1 0 05.11.2011 20 20 2 ways of treatment . were very common in soci- 1. REGISTRATION FEE 1 Nikolas Rose UK of dispute. There are some who 40 Euro Society and mental 04.11.2011 05.11.2011 Steven Rose UK ety and needed to be treat- illness argue that increasingly that ed. That went hand in hand Wulf Rössler CH is possible. Simon Lovestone Sir Michael Rutter UK with the development of the speaking at the conference is one Luca Santarelli CH HIGH SCHOOL new anti-depressants called STUDENTS Organizing committee of those. 05.11.2011 Joseph A. Sergeant NL free entrance Dusan Bartsch Central Institute of Mental 04.11.2011 Health | Mannheim | DE Selective Serotonin Re-uptake Hans-Ullrich Wittchen DE Cornelius Gross European Molecular Biology Laboratory | Monterotondo | IT Andreas Meyer-Lindenberg Central Institute Inhibitors (SSRIs), of which of Mental Health | Mannheim | DE What is your personal highlight Nikolas Rose BIOS | London School of the best known was Prozac. Economics | UK of the upcoming conference? Alessandra Bendiscioli EMBO Science & Society Programme The hypothesis of a neural Holger Breithaupt EMBO reports I’m very pleased that we have Gerlind Wallon EMBO Deputy Director basis of depression and the Contact Halldor Stefansson EMBL Science & Society a talk describing the patients Programme EMBO European Molecular mechanisms of these drugs Biology Organization perspective from Donna Science & Society Programme Meyerhofstr. 1 was almost certainly incorrect. 69117 Heidelberg, Germany Franceschild, who is a writer by S. Krahl © 2011 EMBO | Poster Tel. +49 6221 8891 119 www.embo.org/ Further, the argument about [email protected] science-society-conference-2011 and dramatist for TV and radio their selectivity for depression and has been active in patients’ was soon abandoned, as they movements in psychiatry. In the became prescribed for anxiety, social anxiety of mental processes, but would identify the past, the last persons who were listened to and other disorders. Currently, we see increas- specifi c neural bases of psychiatric problems. about the value of their treatment were the ing interest in methods like deep brain stimu- Some hoped that each symptom had a precise users themselves. I think the emergence of the lation, transcranial magnetic intervention and neurobiological basis that could be identifi ed patient’s voice, the recognition that they have other electrical and magnetic techniques that to aid precise diagnosis and guide a therapy the right to a say in how psychiatry devel- go straight to the brain. that would hit those symptoms without all ops, is applied and evaluated, is as major an the adverse effects associated with the older advance for psychiatry as developments in Did the rapid development of the neuro- psychiatric drugs. That hope spawned a great neuroscience. sciences in the nineties help to diagnose and investment in the development of drugs for treat psychiatric conditions more precisely? psychotic disorders. This was certainly the hope of those who The jury is still out whether or not this will be have supported the spectacular
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