Depression and anxiety-related psychological disorders are costing the global economy $1 trillion annually. Between 1999 and 2013, the number of people suffering from depression and/or anxiety had increased by almost 50%, from 416 million to 615 million. Of which, as a past study found, over half of all patients recruited via primary care and psychiatric clinics, would not achieve remission after first-line antidepressant treatment. While one-third of them would not experience remission after four courses of acute treatment. These treatment-resistant patients are now the window to a new branch of research called precision psychiatry

Brain biology and psychological disorder  

Unlike a medical disease, many researchers believe psychological disorder like depression cannot be treated as a single condition but several separate ailments. Some of them are more likely to trigger a suicide as compared to others. With precision psychiatry, researchers will be looking into respective brain scans, to study neural circuits that light up when specific tasks are performed and how they may correlate with the activations of certain symptoms. 

The rationale of the approach is not to underline biological markers linked to psychological disorders but to provide more tailored care for treatment-resistant patients with brain circuitry; improving overall prognosis and ideally reducing suicide. Although it remains unclear if a targeted approach to depression will prevent a potential suicide, depressed patients do demonstrate certain brain biology. 

For examples, in the early 1980s, Columbia University neuroscientist John Mann had discovered a markedly low levels of neurotransmitter serotonin in depressed individuals. More recently, Yale University neuroscientist Irina Esterlis found 30% more receptors responsible for signaling molecule glutamate in patients with post-traumatic disorder (PTSD), which also triggers suicide. 

The process 

For the Research on Anxiety and Depression-Anhedonia Treatment (RAD-AT) led by Leanna Williams, a Stanford University clinical neuroscientist, recruited volunteers had to undergo functional magnetic resonance imaging (fMRI) scans as they perform a series of mental tasks, which found to correspond with six subtypes of depression. The scans will detect neuronal activities by measuring the changes in blood oxygen levels which in turn reveal how different brain regions fire and coordinate. Ultimately, the information would lead the research team to hypothesize the key to guide subsequent treatments. 

A disadvantage to RAD-AT is the time and expenses required for brain scanning. Whilst Williams had tried to cut down the time from hours to minutes, the research team is now considering whether it will be more efficient to use other vital signs like heart rate to obtain a similar estimation of neuroimaging data. If that is possible, the research team may design a kind of wearable to assist users in monitoring their psychological disorders. Till then, Williams and her team are working towards gathering more evidence. 

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Hazel Tang

A science writer with data background and an interest in the current affair, culture, and arts; a no-med from an (almost) all-med family. Follow on Twitter.