Psynomics - Genomics For The New Psychiatry

Physicians

The Vision

Dramatic advances in human genetics have recently provided powerful tools for identifying the specific genes that cause susceptibility to psychiatric illness. Genes explain 50-70 percent of the cause of most psychiatric disorders. Environmental factors explain the rest. Disease may result from the interaction of genes and environment as shown below.

In addition, mutations in different genes in different physiological pathways may lead to susceptibility to illness. Dysfunction in one or more distinct biological pathways may underlie illness that behaviorally appears the same. For example, several different biological abnormalities may each lead to mania. These different pathways then interact with environmental factors or stresses to produce illness. However, each different pathophysiological abnormality represents a biologically distinct disease. These diseases differ in etiology and differ in prognosis and treatment response. These are the diseases that will form the basis of a new biology- and etiology-based diagnostic system.

The task of identifying all the genes involved is large as there are likely dozens. Science is presently just at the beginning of this process of discovery. However, already several genes have been discovered for bipolar disorder and schizophrenia. Psynomics’ vision is to bring these discoveries to the clinic to aid the physician in the process of diagnosis and treatment.

Pharmacogenetics is a related and rapidly advancing field. Pharmacogenetics refers to the study of genes that influence response to medications. It is a common clinical experience that patients with very similar clinical presentations may have very different responses to medications. It is likely that much of this variation in response is genetically based. The figure below illustrates some of the possible relationships of these genes. Disease resulting from different susceptibility genes may manifest different response to medications. The different biologies involved may be affected by some drugs and not others. Alternatively, other genetic variation in pharmacodynamic genes may influence drug response but not susceptibility to illness. Variation in genes influencing bioavailability may also influence drug response.