A Focus on Individuality in the Treatment of Psychiatric Disorders

A Focus on Individuality in the Treatment of Psychiatric Disorders

Psychiatric disorders have become much less stigmatized and, consequently, much more seemingly prevalent in recent years. As more people have become comfortable seeking help without fear of retribution or being cast out from society, treatment of various psychiatric disorders has transitioned from the degradation of rights and autonomy to a much more humane standard of care in the past few decades. This is reflective of an important shift in the lens through which these disorders are discussed and handled. However, there is still much to be desired in the treatment of individuals who are afflicted with these disorders, as there has been a stronger emphasis placed on research and treatment of the disorders themselves, rather than a focus on how they uniquely affect individuals’ neurobiology and functionality. In order to truly understand the scope of psychiatric diseases and how they affect our population, it is necessary to first look more closely at how they affect people on an individual level. This will be the key to providing more holistic care moving forward and allow researchers, psychiatrists, and physicians alike to address ailments with a need-based system, rather than attempting to apply the same “one size fits all” approach to every person suffering at the hands of their own neural pathways. 

In their research article, titled “Defining Individual-Specific Functional Neuroanatomy for Precision Psychiatry”, Gratton et al. turn their focus towards the utilization of up-and-coming “precision” functional magnetic resonance imaging techniques, attempting to gather more expansive data in individual subjects, rather than confining themselves to the techniques of previously conducted research which has put more of an emphasis on gathering small amounts of data from a larger number of participants. This didn’t mean, however, that the results gleaned wouldn’t be applicable on a larger scale. In fact, they were able to identify many universal regions of abnormal activity, opening the door to evaluate the differences found and relate them to certain experiences and traits that may have been responsible for these malfunctions. They utilized these pfMRI practices along with extensive phenotypic and behavioral measurements, all of which worked to increase the construct and content validity of the research. Doing so allowed them to focus on the overall networking of the brain and identify key differences and similarities between individuals suffering from what appeared diagnostically as the same disease. These pfMRI techniques, while relatively new, have proven to be very useful tools in determining broader areas of malfunction within neuronal pathways. This is important because psychiatric disorders are not often confined to specific regions of the brain, but are rather interfaced across many functional systems and pathways that are responsible for a variety of behavioral and cognitive outputs. 

This overall approach to psychiatric care is not limited to Dr. Gratton and her colleagues, however, as many prominent researchers have been evaluating psychiatric disorders on an individual basis for the past 10 years or so. In “Towards an Approach to Mental Disorders Based on Individual Differences”, Fossati evaluates a paper written by Thomas Widiger detailing the highly integrated nature of psychopathology and personality. His work lends itself to the idea that psychiatric treatment should shift away from the alteration of nature and towards the definition and incorporation of individual differences in personality as a method of explaining the presentation of psychiatric disorders in patients. Individual treatment formulation is deemed necessary in the diagnostic practices of psychiatrists overall, as comorbidity and mutual influences have been found to play a much larger role in the efficacy of varying treatment methods than previously thought. Therefore, rather than focusing on the neurobiological nature of these disorders, it is essential to evaluate all applicable aspects of an individual’s emotions, behaviors, experiences, and genetic differences in order to achieve a holistic understanding of the diseases and those afflicted with them. These considerations were also found to be incredibly important in the prevention of worsening symptoms, even while treatment was being undergone. Inflicting the wrong treatment method on a patient can often exacerbate the symptoms, both internally and externally, causing distress to both the patient and those around them. It is unsafe to assume that because a certain method of treatment is effective in a select number of individuals afflicted with a certain disorder, it will be effective in all individuals who suffer from the same ailment. Rather, the evaluation of an individual’s specific needs in relation to their psychiatric regimen has proven beneficial in the overall outcome of treatment methods as a whole. 

While Dr. Gratton and her colleagues’ work lends statistical and biological evidence to the more analytical nature of Fossati’s and Widiger’s work, they are both incredibly important in supporting an individualized approach to psychiatric treatment. As our world has been sunk into a depressive state over the past year in light of the COVID-19 pandemic, it is more important now than ever to focus on individual needs and allow emotions and behaviors to enter the diagnostic sphere. Rather than advocating for the suppression of feelings and actions that feel natural to various individuals, it is important to take into consideration each and every aspect that makes a person unique when attempting to heal them through psychiatric or psychological treatment. Individualism has been slowly becoming more acceptable in all forms over the past few decades, which means that universal psychiatric practices should reflect this sentiment and allow for their incorporation into everyday practices. This integration of the personal and the psychological is essential in the determination of proper treatment, meaning that increased understanding is equivocal to increased efficacy of psychiatric treatment, as well as a better chance of an optimistic prognosis moving forward. 

References

Fossati A. (2011). Towards an approach to mental disorders based on individual differences. World Psychiatry. 2011;10(2):115-116. doi:10.1002/j.2051-5545.2011.tb00032.x

Gratton, C., Kraus, B. T., Greene, D. J., Gordon, E. M., Laumann, T. O., Nelson, S. M., Dosenbach, N. U. F., & Petersen, S. E. (2020). Defining Individual-Specific Functional Neuroanatomy for Precision Psychiatry. Biological Psychiatry, 88(1), 28–39. https://doi.org/10.1016/j.biopsych.2019.10.026