Currently available means to achieve personalized psychiatry

Bruce M. Cohen , Peter Q. Harris
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Abstract

Psychiatry awaits new biomarkers to guide diagnosis and treatment, but identifying, testing, and applying valid technologies will be an extended process, likely requiring years of development. Meanwhile, numerous features of illness and proven techniques for gathering key information on individual patients are underutilized. Such information includes: Details of current presentation and history, including treatments and outcomes; other medical history, including treatments and outcomes; general health and habits; family history of relevant illnesses; and the personal and social context of each patient’s life and illness. Rarely is enough time allotted or resources made available to obtain all this information. However, these data can be obtained by system modifications including: Offloading some work from the treating psychiatrist to allow more time for discussion, data gathering, and relationship building with the patient; using standardized tools and procedures, such as electronic assessment and tracking tools, to gather and share information; improving means to obtain information from other sources, such as other informants, colleagues treating the patient, and the medical record; and providing easily accessible assessment and treatment guidelines containing evidence-based expert-consensus techniques for matching treatment to individual presentation and circumstances. These approaches can be implemented, by means detailed in the text. Briefly, providing more personalized care requires some shifts in funding, some changes in staffing and communication, and some improvements in electronic data gathering, sharing, and searching. In the service of care, it is incumbent on all involved agencies, institutions, and practices to make these changes in the immediate future.

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目前可用于实现个性化精神病学的手段
精神病学正在等待新的生物标志物来指导诊断和治疗,但识别、测试和应用有效技术将是一个漫长的过程,可能需要多年的发展。同时,疾病的许多特征和收集个别患者关键信息的已证实技术没有得到充分利用。此类信息包括:当前表现和病史的详细信息,包括治疗和结果;其他病史,包括治疗和结果;一般健康和习惯;相关疾病的家族史;以及每个患者的生活和疾病的个人和社会背景。很少有足够的时间或资源来获取所有这些信息。然而,这些数据可以通过系统修改来获得,包括:减轻治疗精神科医生的一些工作,以便有更多的时间进行讨论、数据收集和与患者建立关系;使用标准化工具和程序,如电子评估和跟踪工具,收集和共享信息;改进从其他来源获取信息的手段,如其他线人、治疗患者的同事和病历;以及提供易于获取的评估和治疗指南,其中包含循证专家共识技术,用于将治疗与个人表现和情况相匹配。这些办法可以通过案文中详述的方式加以实施。简言之,提供更个性化的护理需要资金方面的一些转变,人员配置和沟通方面的一些变化,以及电子数据收集、共享和搜索方面的一些改进。在护理服务中,所有相关机构、机构和实践都有责任在不久的将来做出这些改变。
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