Neurociencia en Psiquiatria; hacia una medicina integral y personalizada en el DSM-V: una propuesta. Neuroscience in Psychiatry towards an integrative and personalized medicine in the DSM-V: a proposal.
Abstract
Resumen
En el último siglo la concepción de salud, y con ello de la ciencia médica, ha sufrido un cambio profundo, ontogénico, metanoico. Sin embargo, esta revolución no ha alcanzado de la misma manera a lo que hoy en dÃa llamamos salud mental. En las siguientes páginas se tratará de mostrar, tomando como modelo al Trastorno Depresivo Mayor (TDM), la posibilidad y necesidad que tiene la psicopatologÃa (comportamiento y capacidades “mentalesâ€: intelectivas, racionales, cognitivas, ejecutivas, lingüÃsticas, emocionales, lógico-conceptuales, etc.), de regresar a sus orÃgenes médicos, que le permitirán responder al “cómo†del funcionamiento cerebral y a su relación con el resto del organismo y con el medio ambiente, con el fin de obtener patrones que nos ayuden a definir enfermedad desde una perspectiva etiofisiopatogénica. Ha llegado el momento de cuestionar si hemos inventado una ciencia (psiquiatrÃa) que poco tiene que ver con la realidad, por lo que se propone la creación de bases de datos donde se integren variables biológicas (genéticas, cerebrales, endocrinológicas, inmunológicas, etc.), sociales, personales, clÃnicas, etc., de forma multicéntrica e internacional, para finalmente obtener relaciones que nos permitan una reclasificación de la patologÃa cerebral útil para proporcionar tratamientos integrales y personalizados.
Palabras Claves: DSM-V, neurociencia, psiquiatrÃa, neurobiologÃa, cerebro,
medicina personalizada.
Abstract
In the last Century the concept of health and, with it, medical science, has suffered a profound, conceptual and ontological change. However, this revolution has not reached, in the same way the field of mental health. In the next pages it will be shown, taking Major Depressive Disorder as a model, how it is possible and necessary, for the field of psychopathology (behavior and “mental†functions: rational, executive, cognitive, emotional, etc.) the return to its medical origins, which will allow it to respond how the brain functions and its interactions with the rest of the organism and the environment, with the goal of obtaining patterns that will help us to define disease from an etiopathogenic point of view, so it would be possible to provide therapeutic options to the organ in question. The time has come to ask if we have invented a
science (psychiatry) that has little to do with reality, and to answer that, the creation of multicentric data bases is proposed, in which biological (not just brain based), social, personal, clinical, etc. variables are integrated, to finally obtain correlations that allow us a reclassification of brain pathology that would be useful to offer integral and personalized treatments.
Key Words: DSM-V, neuroscience, psychiatry, neurobiology, brain, personalized
medicine.
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