Neurogenetic Approaches to Advancing Symptom Science in Psychiatric-Mental Health Nursing- Focus on Psychosis and Severe Mental Illnesses

Abstract

It is well-known that Psychiatry and Mental health lags behind other disciplines such as Oncology and Cardiology in this era of precision science. For severe neuropsychiatric conditions such as psychosis and schizophrenia, there is a significant gap in the knowledge of pathophysiological mechanisms that are often attributed to the biological and phenotypic heterogeneity of such disorders. The symptoms of these disorders which cross traditional diagnostic boundaries are often refractory to treatment, and leads to significant morbidity, social and occupational impairments and incur significant personal and societal burden. In addition, patients with severe mental illness suffer from physical and somatic comorbidities which further adds to the burden. For example, schizophrenia, often considered the poster child of severe mental illnesses, carries a higher risk for all-cause mortality (2-3 times higher than the general population) and 15-25 years of reduced life expectancy.

The genetic basis of severe mental illnesses is well established. In addition, evidence from epidemiological and clinical studies often point to the sheer complexity of these illness that involves a combination of polygenetic and environmental causes. Subsequently, there is a need for focus on addressing complex care needs, precision science and clinical translation to advance clinical care. Though advances in genomics have brought to fruition the science of precision medicine by converging the effects of individual variability in genes, environment and life style, the effect of on psychiatric and mental illnesses pales in comparison to other somatic diagnoses. My program of research focuses on elucidating neurobiological mechanisms of psychiatric symptoms that crosses traditional diagnostic boundaries. This has implications for psychiatric mental health nursing research and practice. I will describe the importance of such a line of inquiry, current trends and challenges and the critical need to develop the scientific and the professional psychiatric mental health nursing workforce. The approach of investigating the biological basis of symptoms which are tied to long term adverse outcomes has the potential to identify precise and effective interventions for our patients.