Neurobiology and the Future

Hymen, Steve E. (2003). Diagnosing disorders. Scientific American, 289(3), 96-103.


In the above referenced article, the author, who is a professor of neurobiology at Harvard medical school, discusses the contributions neurobiology will someday make to the field of diagnostics in psychiatric conditions. He points out that because of the subjective nature of psychiatric illnesses it is more of a challenge for two doctors to come up with the same diagnosis. If a person has a broken arm, an x-ray will show any number of doctors that the arm is, in fact, broken. Not so with psychiatric disorders. There is no way to x-ray the brain to ensure that a diagnosis of schizophrenia is correct. Doctors must go by a checklist of symptoms, and often observations of symptoms are in the eye of the beholder.

Through advances in neurobiology, scientist may soon be able to distinguish if a person is susceptible to a mental disorder by their DNA. And due to the rapid progress in neuroimaging, which is the ability to look at the brain without surgery, doctors may soon be able to spot differences in the structures and sequence that predispose persons to different disorders. Early detection would enable more efficient treatment and the slowing down of an aggressive disorder. Early detection is key to controlling mental disorders.

The author catalogs the history of psychiatric diagnosis starting with Emil Kraepelin who was a German scientist in the 19th century. Kraepelin is known for discovering the two most severe mental disorders, schizophrenia and manic-depression, now called bipolar disorder. Much of his work was conducted by following his patients over their lifetimes and documenting their progression.

Sigmund Freud and his followers were next to make contributions to diagnostics in the early 20th century. They utilized psychoanalytic theories that stated symptoms arose due to an individuals in ability to navigate psychological stages of development. The symptoms of an illness determined at what point in the development the trouble arose. This meant that there was no room for brain abnormalities or dysfunctions.

In the 1950’s treatment returned to a more balanced approach. Medication was discovered such as thorazine and lithium that effectively treated schizophrenia and manic-depression, and with the creations of the Diagnostic and Statistical Manuel in the 1980’s, guidelines and checklists were put in place that helped more accurately diagnose disorders.

Now, neuroscience is in the process of changing diagnostics yet again. Because the abnormalities in psychiatric disorders in the brain are subtle, looking into genetics has become an area of concentration. Scientists have already begun to find genetic links that are present in the susceptibility to mental disorders such as schizophrenia and bipolar disorder. It will be exciting to watch the area develop.

I find this field of science and its possibilities both exciting and scary. It is exciting because of how quickly an illness might be addressed in the future. It took ten years for me to find the right medications and to become stable. It is scary because once you start looking into genes, the ability to eliminate them and those who have them is not far behind. This world would be minus some pretty astounding creations if those who had mental illness were eliminated from the gene pool.