Future of psychiatry explored in new issue of Stanford Medicine magazine

Sculpture: Frederico Raya/Photo: Victor Villafuerte

Psychiatry needs to “hug the sciences,” says the chair of the school’s psychiatry department, Laura Roberts, MD, in the new issue of Stanford Medicine magazine.

The lead story in the report, “Inside the head: The future of psychiatry,” describes efforts to end the historic split between psychiatry’s two camps — those favoring psychotherapy and those favoring biological treatments.

Roberts believes that advances in genetics and neuroimaging are already bridging the gulf. “That’s the key to the future, that’s where we discover new ways of understanding neuropsychiatric disease as well as its prevention and optimal treatment,” she said in the lead story. But by treatments, she doesn’t just mean medications. “I can’t imagine a future where psychiatry does not also involve therapy.”

The need to improve psychiatric treatment is urgent. The major methods — psychotherapy and drugs — aren’t working for many people who suffer from mental illness. While psychotherapy is considered the most effective treatment for many conditions, it’s all too common that patients can’t afford it or don’t want to do it. Drugs are often not the answer either, as many patients don’t respond or find the side effects too painful. Furthermore, few new drugs are in the pipeline.

The recent explosion of insights coming from the field of neuroscience is only barely beginning to influence the research and practice of psychiatry — which is not surprising, since neuroscience is not a required subject for most psychiatry trainees. That needs to change, according to leaders such as Roberts, who has helped to launch a course in neuroscience for psychiatry residents, and is introducing additional training for subspecialties such as forensic psychiatry and addiction medicine.

Inside the report:

• The lead article on psychiatry’s tentative embrace of biology, with a particular focus on neuroimaging.
• A Q&A with writer and neurologist Oliver Sacks, MD, on the brain’s amazing recuperative powers.
• A feature on physical treatments for depression, including transcranial magnetic stimulation and deep brain stimulation.
• A look at the neuroscience of addiction.
• A story about giving parents of children with autism the scientific skills to study what therapies and treatments work best for their children.

This issue’s “Plus” section, featuring stories unrelated to the special report, includes:

• An article on the effort to finally figure out what happens inside a brain during a concussion
• A story about what happens when a Stanford professor with a man’s body decides to become a woman, and what this tells us about the health challenges for transgender people.

The magazine, including Web-only features, is available online at http://stanmed.stanford.edu. Print copies are being sent to subscribers. Others can request a copy at (650) 736-0297 or medmag@stanford.edu.

Stanford Medicine is published three times a year by the medical school’s Office of Communication & Public Affairs. Follow @stanmedmag on Twitter.