Abstract:
:It is timely to consider the ethical and social questions raised by progress in pharmacogenomics, based on the current importance of pharmacogenomics for avoidance of predictable side effects of drugs, and for correct choice of medications in certain cancers. It has been proposed that the entire population be genotyped for drug-metabolizing enzyme polymorphisms, as a measure that would prevent many untoward and dangerous drug reactions. Pharmacologic treatment targeting based on genomics of disease can be expected to increase greatly in the coming years. Policy and ethical issues exist on consent for large-scale genomic pharmacogenomic data collection, public vs corporate ownership of genomic research results, testing efficacy and safety of drugs used for rare genomic indications, and accessibility of treatments based on costly research that is applicable to relatively few patients. In major psychiatric disorders and intellectual deficiency, rare and de novo deletion or duplication of chromosomal segments (copy number variation), in the aggregate, are common causes of increased risk. This implies that the policy problems of pharmacogenomics will be particularly important for the psychiatric disorders. :Es oportuno tener en cuenta las preguntas éticas y sociales que surgen del progreso en la farmacogenómíca, dada la importancía actual de ésta para evitar los efectos secundarios predecíbles de los fármacos y para la elección correcta de medícamentos en ciertos tipos de cáncer. Se ha propuesto que se le realice el genotipo para el polimorfismo de las enzimas metabolizadoras de fármacos a toda la población, como una medida que podría prevenir muchas reacciones adversas y peligrosas a fármacos. Se puede esperar que el tratamiento farmacológico focalizado basado en la genómica de la enfermedad aumente de manera importante en los próximos años. Existen aspectos políticos y éticos en el consentimiento de la obtención a gran escala de datos genómicos/farmacogenómicos, en la propiedad pública versus privada de los resultados de la investigación genómica, en las pruebas de eficacia y seguridad de fármacos utilizados en indicaciones genómicas raras, y en la accesibilidad a tratamientos basados en costosa investigación que sea aplicable a relativamente pocos pacientes. La deleción rara y de novo o la duplicación de segmentos cromosómicos (variación en el número de copias) son en general causas comunes de aumento del riesgo de los principales trastornos psiquiátricos y del déficit intelectual. Esto implica que los problemas políticos de la farmacogenómica serán especialmente importantes para los trastornos psiquiátricos. :Les progrès de la pharmacogénomique pour éviter les effets indésirables prévisibles des médicaments et pour choisir correctement les traitements dans certains cancers, ont soulevé des questions éthiques et sociales qu'il est temps d'examiner. Le génotypage de la population entière pour les polymorphismes enzymatiques métabolisant les médicaments a été proposé afin de prévenir des effets indésirables nocifs et dangereux. Le ciblage des traitements pharmacologiques fondé sur la génomique va vraisemblablement augmenter considérablement durant les années à venir. Des questions éthiques et politiques se posent au sujet de l'autorisation du recueil de grande envergure des données génomiques et pharmacogénomiques, de la propriété publique vs privée des données de recherche génomique, des essais d'efficacité et de sécurité d'emploi des médicaments utilisés pour des indications génomiques rares, et de l'accessibilité des traitements basés sur une recherche coûteuse bénéficiant à relativement peu de patients. Dans les troubles psychiatriques majeurs et la déficience intellectuelle, la délétion rare et de novo de segments chromosomiques ou leur duplication (variation du nombre de copies), sont dans l'ensemble des causes courantes d'augmentation du risque. Ceci signifie que les questions de politiques publiques par rapport à la pharmacogénomique seront particulièrement importantes avec les troubles psychiatriques.
journal_name
Dialogues Clin Neuroscijournal_title
Dialogues in clinical neuroscienceauthors
Gershon ES,Alliey-Rodriguez N,Grennan Ksubject
Has Abstractpub_date
2014-12-01 00:00:00pages
567-74issue
4eissn
1294-8322issn
1958-5969journal_volume
16pub_type
杂志文章,评审abstract::In 2003, we proposed the hypersystemizing theory of autism. The theory proposes that the human mind possesses a systemizing mechanism (SM) that helps identify lawful regularities (often causal) that govern the input-operation-output workings of a system. The SM can be tuned to different levels, from low to high, with ...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2017-12-01 00:00:00
abstract::Alcohol dependence (alcoholism) is a complex disorder attributed to the interaction of genetic and environmental factors that form a collage of "disease" predisposition, which is not identical for every alcohol-dependent individual. There is considerable evidence to demonstrate that genetic predisposition accounts for...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2005-01-01 00:00:00
abstract::Major depressive disorder (MDD) is a major public health concern. Despite tremendous advances, the pathogenic mechanisms associated with MDD are still unclear. Moreover, a significant number of MDD subjects do not respond to the currently available medication. MicroRNAs (miRNAs) are a class of small noncoding RNAs tha...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2014-03-01 00:00:00
abstract::Mental disorders represent a significant public health burden worldwide due to their high prevalence, chronically disabling nature, and substantial impact on quality of life. Despite growing knowledge of the pathological mechanisms that underlie the development of these disorders, a high percentage of patients do not ...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章
doi:10.31887/DCNS.2020.22.3/pfadda
更新日期:2020-09-01 00:00:00
abstract::Recent research has overcome the old paradigms of the brain as an immunologically privileged organ, and of the exclusive role of neurotransmitters and neuropeptides as signal transducers in the central nervous system. Growing evidence suggests that the signal proteins of the immune system - the cytokines - are also in...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章
doi:
更新日期:2003-06-01 00:00:00
abstract::An evidence-based review of nonpharmacological treatments for anxiety disorders is presented. The vast majority of the controlled research is devoted to cognitive behavior therapy (CBT) and shows its efficiency and effectiveness in all the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) ...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract::Losing a loved to suicide is one is one of life's most painful experiences. The feelings of loss, sadness, and loneliness experienced after any death of a loved one are often magnified in suicide survivors by feelings of quilt, confusion, rejection, shame, anger, and the effects of stigma and trauma. Furthermore, surv...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2012-06-01 00:00:00
abstract::The insights of ethology-the science of animal behavior from a biological and psychological point of view-were incorporated in the 1950s by the British developmental psychiatrist, John Bowlby, into his attachment theory, which argued that a secure affective base in infancy was critical to the normal development of per...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2005-01-01 00:00:00
abstract::Caffeine is not considered addictive, and in animals it does not trigger metabolic increases or dopamine release in brain areas involved in reinforcement and reward. Our objective was to measure caffeine effects on cerebral perfusion in humans using single photon emission computed tomography with a specific focus on a...
journal_title:Dialogues in clinical neuroscience
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2010-01-01 00:00:00
abstract::The first generation of antipsychotic drugs was discovered in the 1960s and 1970s, These agents were effective in treating psychosis, but were accompanied by significant side effects, including severe parkinsonism and akathisia. Second-generation antipsychotics were introduced in the 1990s, These drugs have at least e...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract::Several structural deviances in the brain in "endogenous psychoses" have been described over the last decades. The enlargement of the lateral ventricles and the subtle structural deficits in temporobasal and orbital frontal structures (hypofrontality) are reasonably well established in the majority of schizophrenic pa...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2006-01-01 00:00:00
abstract::We review critical trends in imaging genetics as applied to schizophrenia research, and then discuss some future directions of the field. A plethora of imaging genetics studies have investigated the impact of genetic variation on brain function, since the paradigm of a neuroimaging intermediate phenotype for schizophr...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2013-09-01 00:00:00
abstract::Brain plasticity is an intrinsic characteristic of the nervous system that allows continuous remodeling of brain functions in pathophysiological conditions. Although normal aging is associated with morphological modifications and decline of cerebral functions, brain plasticity is at least partially preserved in elderl...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2013-03-01 00:00:00
abstract::There is mounting evidence that recurrent mood disorders - once considered "good prognosis diseases"- are, in fact, often very severe and life-threatening illnesses. Furthermore, although mood disorders have traditionally been conceptualized as neurochemical disorders, there is now evidence from a variety of sources d...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章
doi:
更新日期:2002-03-01 00:00:00
abstract::Contemporary biological psychiatry uses experimental animal models to increase our understanding of affective disorder pathogenesis. Modern anxiolytic drug discovery mainly targets specific pathways and molecular determinants within a single phenotypic domain. However, greater understanding of the mechanisms of action...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2015-09-01 00:00:00
abstract::The current clinical use of psychotropic drugs is transnosologically oriented. This is facilitated by the current classification of mental disorders (International Classification of Diseases, 10th Revision [ICD-10]) and is perhaps justified if depression and psychosis (taken here as examples) are considered as being c...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章
doi:
更新日期:1999-12-01 00:00:00
abstract::Wider use of pharmacological models would facilitate the development of new drugs for Alzheimer's disease (AD), The two main models currently used are based on the cholinergic and glutamatergic hypotheses of AD, Although they lead to some of the attention and memory impairment observed in AD, they do not fully reprodu...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract::The study of molecular clock mechanisms in psychiatric disorders is gaining significant interest due to data suggesting that a misalignment between the endogenous circadian system and the sleep-wake cycle might contribute to the clinical status of patients suffering from a variety of psychiatric disorders. Sleep distu...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2007-01-01 00:00:00
abstract::Understanding individual response to a drug-what determines its efficacy and tolerability-is the major bottleneck in current drug development and clinical trials. Intracellular response and metabolism, for example through cytochrome P-450 enzymes, may either enhance or decrease the effect of different drugs, dependent...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2006-01-01 00:00:00
abstract::Over the last few years, neuroimaging techniques have contributed greatly to the identification of the structural and functional neuroanatomy of anxiety disorders. The amygdala seems to be a crucial structure for fear and anxiety, and has consistently been found to be activated in anxiety-provoking situations. Apart f...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2011-01-01 00:00:00
abstract::Technology in genetics and brain imaging has advanced so rapidly that it is difficult to be knowledgeable about all the new tools being used in the pursuit of progress toward understanding and treating mental illness. While findings from new studies remain promising, caution is needed with regard to their current appl...
journal_title:Dialogues in clinical neuroscience
pub_type: 社论
doi:
更新日期:2014-12-01 00:00:00
abstract::Epidemiological studies show that anxiety disorders are highly prevalent and an important cause of functional impairment; they constitute the most frequent menial disorders in the community. Phobias are the most common with the highest rates for simple phobia and agoraphobia. Panic disorder (PD) and obsessive-compulsi...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章
doi:
更新日期:2003-09-01 00:00:00
abstract::Increased physician prescribing of opioids to treat chronic nonprogressive pain has been accompanied by an increase in opioid addiction. Twin studies of opioid addiction are consistent with an inherited component of risk, approximately 50%. Several genome-wide association study (GWAS) reports indicate that genetic ris...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2017-09-01 00:00:00
abstract::The introduction of biological markers in the clinical management of Alzheimer's disease (AD) will not only improve diagnosis relating to early detection of neuropathology with underlying molecular mechanisms, but also provides tools for the assessment of objective treatment benefits. In this review, we identify a num...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2009-01-01 00:00:00
abstract::Impairment of cognitive function is the central feature of dementia. Although, clinically, the cognitive deficit most often manifests itself as memory problems, a number of other areas of cognition are affected, and memory is but one of the cognitive skills compromised in dementia. Dementia with Lewy bodies, for examp...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章
doi:
更新日期:2003-03-01 00:00:00
abstract::With his early publications (1910-1913), Karl Jaspers created a comprehensive methodological arsenal for psychiatry, thus laying the foundation for descriptive psychopathology. Following Edmund Husserl, the founder of philosophical phenomenology, Jaspers introduced phenomenology into psychopathology as "static underst...
journal_title:Dialogues in clinical neuroscience
pub_type: 传,历史文章,杂志文章
doi:
更新日期:2015-03-01 00:00:00
abstract::It is clinically important to recognize both bipolar disorder and borderline personality disorder (BPD) in patients seeking treatment for depression, and it is important to distinguish between the two. Research considering whether BPD should be considered part of a bipolar spectrum reaches differing conclusions. We re...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2013-06-01 00:00:00
abstract::Development of the characteristics of social phobia often requires a diathesis in the form of a temperamental bias. A behavioral profile marked by vigorous motor activity and crying to unfamiliar stimuli at 4 months of age - called high reactivity- is characteristic of about 20% of healthy, Caucasian infants. This pat...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract::Post-traumatic stress disorder (PTSD) may be associated with long-lasting psychological suffering, distressing psychosocial disability, markedly reduced health-related quality of life, and increased morbidity and mortality in a subgroup of individuals in the aftermath of serious traumatic events. Both etiopathogenesis...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2014-06-01 00:00:00
abstract::Schizophrenia (SZ) and bipolar disorder (BPD) patients show a downregulation of GAD67, reelin (RELN), brain-derived neurotrophic factor (BDNF), and other genes expressed in telencephalic GABAergic and glutamatergic neurons. This downregulation is associated with the enrichment of 5-methylcytosine and 5-hydroxymethylcy...
journal_title:Dialogues in clinical neuroscience
pub_type: 杂志文章,评审
doi:
更新日期:2014-09-01 00:00:00