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False dogmas in mood disorders research:Towards a nomothetic network approach

World Journal of Psychiatry 2022年第5期12卷 651-667页

作者： Michael HJ Maes drozdstoy stoyanov Department of Psychiatry Chulalongkorn UniversityBangkok 10330Thailand Department of Psychiatry Medical University PlovdivPlovdiv 4000Bulgaria

The current understanding of major depressive disorder(MDD)and bipolar disorder(BD)is plagued by a cacophony of controversies as evidenced by competing schools to understand MDD/*** DSM/ICD taxonomies have cemented their status as the gold standard for diagnosing MDD/*** aim of this review is to discuss the false dogmas that reign in current MDD/BD research with respect to the new,data-driven,machine learning method to model psychiatric illness,namely nomothetic network psychiatry(NNP).This review discusses many false dogmas including:MDD/BD are mind-brain disorders that are best conceptualized using a bio-psycho-social model or mind-brain interactions;mood disorders due to medical disease are attributable to psychosocial stress or chemical imbalances;DSM/ICD are the gold standards to make the MDD/BD diagnosis;severity of illness should be measured using rating scales;clinical remission should be defined using threshold values on rating scale scores;existing diagnostic BD boundaries are too restrictive;and mood disorder spectra are the *** contrast,our NNP models show that MDD/BD are not mind-brain or psycho-social but systemic medical disorders;the DSM/ICD taxonomies are counterproductive;a shared core,namely the reoccurrence of illness(ROI),underpins the intertwined recurrence of depressive and manic episodes and suicidal behaviors;mood disorders should be ROI-defined;ROI mediates the effects of nitro-oxidative stress pathways and early lifetime trauma on the phenome of mood disorders;severity of illness and treatment response should be delineated using the NNP-derived causome,pathway,ROI and integrated phenome scores;and MDD and BD are the same illness.

关键词： Nomothetic network psychiatry Depression Mood disorders Affective disorders Inflammation Oxidative and nitrosative stress Neuro-immune

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Functional magnetic resonance imaging study of group independent components underpinning item responses to paranoid-depressive scale

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World Journal of Clinical Cases 2023年第36期11卷 8458-8474页

作者： drozdstoy stoyanov Rositsa Paunova Julian Dichev Sevdalina Kandilarova Vladimir Khorev Semen Kurkin Department of Psychiatry Medical University PlovdivPlovdiv 4000Bulgaria Research Institute Medical UniversityPlovdiv 4002Bulgaria Faculty of Medicine Medical UniversityPlovdiv 4002Bulgaria Department of Psychiatry and Medical Psychology Medical UniversityPlovdiv 4002Bulgaria Baltic Center for Artificial Intelligence and Neurotechnology Immanuel Kant Baltic Federal UniversityKaliningrad 236041Russia

BACKGROUND Our study expand upon a large body of evidence in the field of neuropsychiatric imaging with cognitive,affective and behavioral tasks,adapted for the functional magnetic resonance imaging(MRI)(fMRI)experimental *** is sufficient evidence that common networks underpin activations in task-based fMRI across different mental *** To investigate whether there exist specific neural circuits which underpin differ-ential item responses to depressive,paranoid and neutral items(DN)in patients respectively with schizophrenia(SCZ)and major depressive disorder(MDD).METHODS 60 patients were recruited with SCZ and *** patients have been scanned on 3T magnetic resonance tomography platform with functional MRI paradigm,comprised of block design,including blocks with items from diagnostic paranoid(DP),depression specific(DS)and DN from general interest *** performed a two-sample t-test between the two groups-SCZ patients and depressive *** purpose was to observe different brain networks which were activated during a specific condition of the task,respectively DS,DP,*** Several significant results are demonstrated in the comparison between SCZ and depressive groups while performing this *** identified one component that is task-related and independent of condition(shared between all three conditions),composed by regions within the temporal(right superior and middle temporal gyri),frontal(left middle and inferior frontal gyri)and limbic/salience system(right anterior insula).Another com-ponent is related to both diagnostic specific conditions(DS and DP)*** is shared between DEP and SCZ,and includes frontal motor/language and parietal *** specific component is modulated preferentially by to the DP condition,and is related mainly to prefrontal regions,whereas other two components are significantly modulated with the DS condition and include clusters within the default mode network such as posterior cingulate and prec

关键词： Paranoid-depressive scale Functional magnetic resonance imaging Cross-validation Group independent component analysis Schizophrenia Depression

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How to construct neuroscience-informed psychiatric classification?Towards nomothetic networks psychiatry

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World Journal of Psychiatry 2021年第1期11卷 1-12页

作者： drozdstoy stoyanov Michael HJ Maes Department of Psychiatry and Medical Psychology Research InstituteMedical University of PlovdivPlovdiv 4000Bulgaria Department of Psychiatry Deakin UniversityGeelong 3220Australia

Psychiatry remains in a permanent state of crisis,which fragmented psychiatry from the field of *** crisis in psychiatry is evidenced by the many different competing approaches to psychiatric illness including psychodynamic,biological,molecular,pan-omics,precision,cognitive and phenomenological psychiatry,folk psychology,mind-brain dualism,descriptive psychopathology,and *** current“gold standard”Diagnostic and Statistical Manual of Mental Disorders/International Classification of Diseases taxonomies of mood disorders and schizophrenia are unreliable and preclude to employ a deductive reasoning ***,it is not surprising that mood disorders and schizophrenia research was unable to revise the conventional classifications and did not provide more adequate therapeutic *** aim of this paper is to explain the new nomothetic network psychiatry(NNP)approach,which uses machine learning methods to build data-driven causal models of mental illness by assembling risk-resilience,adverse outcome pathways(AOP),cognitome,brainome,staging,symptomatome,and phenomenome latent scores in a causal *** latter may be trained,tested and validated with Partial Least Squares *** approach not only allows to compute pathway-phenotypes or biosignatures,but also to construct reliable and replicable nomothetic networks,which are,therefore,generalizable as disease *** integrating the validated feature vectors into a well-fitting nomothetic network,clustering analysis may be applied on the latent variable scores of the R/R,AOP,cognitome,brainome,and phenome latent *** pattern recognition method may expose new(transdiagnostic)classes of patients which if cross-validated in independent samples may constitute new(transdiagnostic)nosological categories.

关键词： Psychiatry Major depression Mood disorders Schizophrenia Antioxidants Oxydative stress

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Implications from translational cross-validation of clinical assessment tools for diagnosis and treatment in psychiatry

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World Journal of Psychiatry 2021年第5期11卷 169-180页

作者： Katrin Aryutova Rositsa Paunova Sevdalina Kandilarova Anna Todeva-Radneva drozdstoy stoyanov Department of Psychiatry and Medical Psychology Scientific Research InstituteMedical University of PlovdivPlovdiv 4002Bulgaria

Traditional therapeutic methods in psychiatry,such as psychopharmacology and psychotherapy help many people suffering from mental disorders,but in the long-term prove to be effective in a relatively small proportion of those ***,resistant forms of mental disorders such as schizophrenia,major depressive disorder,and bipolar disorder lead to persistent distress and dysfunction in personal,social,and professional *** an effort to address these problems,the translational approach in neuroscience has initiated the inclusion of novel or modified unconventional diagnostic and therapeutic techniques with promising *** instance,neuroimaging data sets from multiple modalities provide insight into the nature of pathophysiological mechanisms such as disruptions of connectivity,integration,and segregation of neural networks,focusing on the treatment of mental disorders through instrumental biomedical methods such as electro-convulsive therapy(ECT),transcranial magnetic stimulation(TMS),transcranial direct current stimulation(tDCS)and deep brain stimulation(DBS).These methodologies have yielded promising results that have yet to be understood and improved to enhance the prognosis of the severe and persistent psychotic and affective *** current review is focused on the translational approach in the management of schizophrenia and mood disorders,as well as the adaptation of new transdisciplinary diagnostic tools such as neuroimaging with concurrently administered psychopathological questionnaires and integration of the results into the therapeutic framework using various advanced instrumental biomedical tools such as ECT,TMS,tDCS and DBS.

关键词： Translational neuroscience Evidence-based psychiatry Schizophrenia Affective disorders Psychopharmacology Electro-convulsive therapy Transcranial magnetic stimulation Transcranial direct current stimulation Deep brain stimulation

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Differential aberrant connectivity of precuneus and anterior insula may underpin the diagnosis of schizophrenia and mood disorders

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World Journal of Psychiatry 2021年第12期11卷 1274-1287页

作者： Katrin Aryutova Rositsa Paunova Sevdalina Kandilarova Kristina stoyanova Michael HJ Maes drozdstoy stoyanov Psychiatry and Medical Psychology Medical UniversityPlovdiv 4002Bulgaria Research Institute Medical UniversityPlovdiv 4002Bulgaria

BACKGROUND Over the past decade,resting-state functional magnetic resonance imaging(rsfMRI)has concentrated on brain networks such as the default mode network(DMN),the salience network(SN),and the central executive network(CEN),allowing for a better understanding of cognitive deficits observed in mental disorders,as well as other characteristic psychopathological phenomena such as thought and behavior *** To investigate differential patterns of effective connectivity across distributed brain networks involved in schizophrenia(SCH)and mood *** The sample comprised 58 patients with either paranoid syndrome in the context of SCH(n=26)or depressive syndrome(Ds)(n=32),in the context of major depressive disorder or bipolar *** methods used include rs-fMRI and subsequent dynamic causal modeling to determine the direction and strength of connections to and from various nodes in the DMN,SN and *** A significant excitatory connection from the dorsal anterior cingulate cortex to the anterior insula(aI)was observed in the SCH patient group,whereas inhibitory connections from the precuneus to the ventrolateral prefrontal cortex and from the aI to the precuneus were observed in the Ds *** The results delineate specific patterns associated with SCH and Ds and offer a better explanation of the underlying mechanisms of these disorders,and inform differential diagnosis and precise treatment targeting.

关键词： Schizophrenia Major depressive disorder Bipolar disorder Resting-state functional magnetic resonance imaging effective connectivity precuneus insula default mode network salience network

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