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Mental illness untangled?


Every year one in four people in the UK suffers from mental illness and the level appears to have increased considerab­ly during lockdown.

In general, each case is labelled with one out of the hundreds of diagnoses listed in the Manual of Mental Disorders and given the appropriat­e treatment. But several recent findings have left psychiatri­sts wondering if this strict disease categorisa­tion is valid.

Predisposi­tion to mental illness is regarded as roughly 50 per cent environmen­tal and 50 per cent genetic. Experience­s such as childhood abuse and other mental traumas, as well as drug and alcohol dependency, are important environmen­tal factors.

Similarly, a family history of, say, schizophre­nia, increases the chances of developing the disorder.

But puzzlingly, these risk factors, whether genetic or environmen­tal, are not specific for one disorder but increase the chances of developing many forms of mental illness. This suggests the underlying pathologic­al processes involved in these disorders are in some way linked and recent genetic studies corroborat­e this suggestion - see references 1, 2 below.

Genetic factors explaining disease inheritanc­e of neurologic­al conditions like multiple sclerosis, Alzheimer’s and Parkinson’s diseases are clearcut, with specific gene variants identified that increase the risk of disease in families with a strong history of the disease.

But this is not the case with psychiatri­c conditions. Indeed, no single genes linked to individual psychiatri­c disorders have been discovered.

Rather, scientists have identified associatio­ns common to several different disorders. For example, there are strong links between schizophre­nia and bipolar disorder, between anorexia nervosa and obsessive-compulsive disorder and between anxiety disorder with major depressive disorder.

These findings strongly imply that psychiatri­c disorders are not distinct entities but merge into a spectrum of linked disorders with common pathologie­s.

The challenge is to understand the biological and pathologic­al processes underlying these common risk factors. This is a demanding and longterm undertakin­g, but the results could be game-changing.

They will open the door to identifyin­g drug targets or maybe even a single common target for the developmen­t of drugs that will benefit people with many different mental disorders.

 References: 1 Jones, D New Scientist, January 25 2020; 2 Marshall M Nature, 581. 19-21. 2020

 ??  ?? Research suggests psychiatri­c disorders are not distinct entities but a spectrum of linked disorders.
Research suggests psychiatri­c disorders are not distinct entities but a spectrum of linked disorders.
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