The risk that neurogenetic approaches may inflate the psychiatric concept of disease and how to cope with it
Tóm tắt
Currently, there is a growing interest in combining genetic information with physiological data measured by functional neuroimaging to investigate the underpinnings of psychiatric disorders. The first part of this paper describes this trend and provides some reflections on its chances and limitations. In the second part, a thought experiment using a commonsense definition of psychiatric disorders is invoked in order to show how information from this kind of research could be used and potentially abused to “invent” new mental illnesses. It is then argued why an inference to the best explanation could provide an antidote to such attempts. The conclusion emphasises why normative criteria, such as those used to define disorders, cannot be derived from descriptive empirical results alone. While the etiology of some psychiatric diseases may be purely organic, there are many other cases where the psychiatric symptoms and the associated genotypes and phenotypes have an essentially and irreducibly external meaning that is derived from social and political factors. A limited perspective on the genes and brain of man carries the risk that psychiatry may increasingly treat the effects of other domains, although social and political solutions would be more appropriate.
Tài liệu tham khảo
Bartelborth T (2002) Begründungsstrategien. Ein Weg durch die analytische Erkenntnistheorie. Akademie Verlag, Berlin
Caldwell JA, Caldwell JL, Smythe NK, Hall KK (2000) A double-blind, placebo-controlled investigation of the efficacy of modafinil for sustaining the alertness and performance of aviators: a helicopter simulator study. Psychopharmacology 150:272–282 10.1007/s002130000450
Caspi A, Moffitt TE (2006) Opinion–Gene–environment interactions in psychiatry: Joining forces with neuroscience. Nat Rev Neurosci 7:583–590 10.1038/nrn1925
Caspi A, Sugden K, Moffitt TE, Taylor A, Craig IW, Harrington H, McClay J, Mill J, Martin J, Braithwaite A, Poulton R (2003) Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science 301:386–389 10.1126/science.1083968
Chatterjee A (2006) The promise and predicament of cosmetic neurology. J Med Ethics 32:110–113 10.1136/jme.2005.013599
Check E (2005) Ethicists urge caution over emotive power of brain scans. Nature 435:254–255 10.1038/435254a
Durston S, Fossella JA, Casey BJ, Pol HEH, Galvan A, Schnack HG, Steenhuis MP, Minderaa RB, Buitelaar JK, Kahn RS, van Engeland H (2005) Differential effects of DRD4 and DAT1 genotype on fronto-striatal gray matter volumes in a sample of subjects with attention deficit hyperactivity disorder, their unaffected siblings, and controls. Mol Psychiatry 10:678–685 10.1038/sj.mp.4001649
Ebstein RP (2006) The molecular genetic architecture of human personality: beyond self-report questionnaires. Mol Psychiatry 11:427–445 10.1038/sj.mp.4001814
Flint J, Munafo MR (2007) The endophenotype concept in psychiatric genetics. Psychol Med 37:163–180 10.1017/S0033291706008750
Ford J, Farid H, Makedon F, Flashman LA, McAllister TW, Megalooikonomou V, Saykin AJ (2003) Patient classification of fMRI activation maps. Med Comput Comput Assist Interv 2879:58–65
Friedman RC, Green R, Spitzer RL (1976) Reassessment of homosexuality and transsexualism. Annu Rev Med 27:57–62 10.1146/annurev.me.27.020176.000421
Gazzaniga MS (2005) The ethical brain. Dana Press, New York
Gill M, Haerich P, Westcott K (2006) Cognitive performance following modafinil versus placebo in sleep-deprived emergency physicians: a double-blind randomized crossover study. Acad Emerg Med 13:477 10.1111/j.1553-2712.2006.tb00334.x
Hariri AR, Drabant EM, Munoz KE, Kolachana LS, Mattay VS, Egan MF, Weinberger DR (2005) A susceptibility gene for affective disorders and the response of the human amygdala. Arch Gen Psychiatry 62:146–152 10.1001/archpsyc.62.2.146
Haynes JD, Rees G (2006) Decoding mental states from brain activity in humans. Nat Rev Neurosci 7:523–534 10.1038/nrn1931
Holtzman NA, Marteau TM (2000) Will genetics revolutionize medicine? N Engl J Med 343:141–144 10.1056/NEJM200007133430213
Ingvar DH, Franzen G (1974) Abnormalities of cerebral blood-flow distribution in patients with chronic schizophrenia. Acta Psychiatr Scand 50:425–462 10.1111/j.1600-0447.1974.tb09707.x
Kim J (2005) Physicalism or something near enough. Princeton University Press, Princeton
Kontos D, Megalooikonomou V, Pokrajac D, Lazarevic A, Obradovic Z, Boyko OB, Ford J, Makedon F, Saykin AJ (2004) Extraction of discriminative functional MRI activation patterns and an application to Alzheimer’s disease. Med Image Comput Comput Assist Interv 3217:727–735
Leonhard K (2003) Aufteilung der endogenen Psychosen und ihre differenzierte Ätiologie, 8th edn. Georg Thieme, Stuttgart
Meyer-Lindenberg A, Straub RE, Lipska BK, Verchinski BA, Goldberg T, Callicott JH, Egan MF, Huffaker SS, Mattay VS, Kolachana B, Kleinman JE, Weinberger DR (2007) Genetic evidence implicating DARPP-32 in human frontostriatal structure, function, and cognition. J Clin Invest 117:672–682 10.1172/JCI30413
Meyer-Lindenberg A, Weinberger DR (2006) Intermediate phenotypes and genetic mechanisms of psychiatric disorders. Nat Rev Neurosci 7:818–827 10.1038/nrn1993
Norman KA, Polyn SM, Detre GJ, Haxby JV (2006) Beyond mind-reading: multi-voxel pattern analysis of fMRI data. Trends Cogn Sci 10:424–430 10.1016/j.tics.2006.07.005
Ponseti J, Bosinski HA, Wolff S, Peller M, Jansen O, Mehdorn HM, Buchel C, Siebner HR (2006) A functional endophenotype for sexual orientation in humans. Neuroimage 33:825–833 10.1016/j.neuroimage.2006.08.002
Robert JS, Plantikow T (2005) Genetics, neuroscience and psychiatric classification. Psychopathology 38:215–218 10.1159/000086095
Roffman JL, Weiss AP, Goff DC, Rauch SL, Weinberger DR (2006) Neuroimaging-genetic paradigms: a new approach to investigate the pathophysiology and treatment of cognitive deficits in schizophrenia. Harv Rev Psychiatry 14:78–91 10.1080/10673220600642945
Rohde LA, Roman T, Szobot C, Cunha RD, Hutz MH, Biederman J (2003) Dopamine transporter gene, response to methylphenidate and cerebral blood flow in attention-deficit/hyperactivity disorder: a pilot study. Synapse 48:87–89 10.1002/syn.10186
Rutter M (2007) Gene–environment interdependence. Dev Sci 10:12–18 10.1111/j.1467-7687.2007.00557.x
Schleim S (2008) Gedankenlesen. Pionierarbeit der Hirnforschung. Heise, Hannover
Schleim S, Schnell K, Walter H (2007) Perspectives on psychopharmacological enhancement. Newsl Eur Acad Sci Study Consequences Sci Tech Adv 73:1–3
Schleim S, Walter H (2007) Cognitive Enhancement: Fakten und Mythen. Nervenheilkunde 26:83–87
Schneider F, Fink GR (2007) Funktionelle MRT in Psychiatrie und Neurologie. Springer, Heidelberg
Singh J, Hallmayer J, Illes J (2007) Science and society––interacting and paradoxical forces in neuroscience and society. Nat Rev Neurosci 8:153–160 10.1038/nrn2073
Turner DC, Robbins TW, Clark L, Aron AR, Dowson J, Sahakian BJ (2003) Cognitive enhancing effects of modafinil in healthy volunteers. Psychopharmacology 165:260–269
Turner DC, Sahakian BJ (2006) Neuroethics of cognitive enhancement. Biosocieties 1:113–123 10.1017/S1745855205040044
Vastag B (2004) Poised to challenge need for sleep, “wakefulness enhancer” rouses concerns. JAMA 291:167–170 10.1001/jama.291.2.167
Walter H (2005) Funktionelle Bildgebung in Psychiatrie und Psychotherapie: Methodische Grundlagen und klinische Anwendungen. Schattauer, Stuttgart
Wesensten NJ, Killgore WDS, Balkin TJ (2005) Performance and alertness effects of caffeine, dextro amphetamine, and modafinil during sleep deprivation. J Sleep Res 14:255–266 10.1111/j.1365-2869.2005.00468.x
Wilford BB, Smith DE, Bucher R (2005) Prescription stimulant sales on the Internet. Psychiatr Ann 35:241–252
Winterer G, Hariri AR, Goldman D, Weinberger DR (2005) Neuroimaging and human genetics. Neuroimaging 67:325–383