The Mental Health Crisis and Incorporating New Understandings

It's hard to see how we get out of our current mental health crisis without incorporating the new understandings of "Immuno-Neuro-Psychiatry."

Further, researchers haven't quite settled on a TERM for this new Age in Psychiatry.  Contenders:

• Immunoneuropsychiatry
• Immunopsychiatry
• Psychoneuroendocrin-ology
• ​Psychoneuroimmunology
• etc.

But these NEW UNDERSTANDINGS are GAME CHANGERS.

Under the current regime of Translational Research and Medicine in the US:  Clinicians will be on top of these new understandings in 10 to 20 years.

But the US has Hundreds of Thousands of People who are Incarcerated and Homeless and/or Punished in Other Ways for Neuro-Developmental and Psychiatric Disorders.

We need to continue our move to a PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE while maintaining safety.

Further, we need greater investments in Translational Research and Medicine for the benefit of Clinicians, Patients and Policy Makers.

​
Immunoneuropsychiatry -
novel perspectives on brain disorders (2019)

​Affiliations
1Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
2Inserm, U955, Institut Mondor de la Recherche Biomédicale, Créteil, France.
3Fondation FondaMental, Créteil, France.
4AP-HP, Department of Psychiatry of Mondor University Hospital, DHU PePsy, University of Paris-Est-Créteil, Créteil, France.
5Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany. [email protected].

Abstract
Immune processes have a vital role in CNS homeostasis, resilience and brain reserve. Our cognitive and social abilities rely on a highly sensitive and fine-tuned equilibrium of immune responses that involve both innate and adaptive immunity.

Autoimmunity, chronic inflammation, infection and psychosocial stress can tip the scales towards disruption of higher-order networks.

However, not only classical neuroinflammatory diseases, such as multiple sclerosis and autoimmune encephalitis, are caused by immune dysregulation that affects CNS function.

Recent insight indicates that similar processes are involved in psychiatric diseases such as schizophrenia, autism spectrum disorder, bipolar disorder and depression.

Pathways that are common to these disorders include microglial activation, pro-inflammatory cytokines, molecular mimicry, anti-neuronal autoantibodies, self-reactive T cells and disturbance of the blood-brain barrier.

These discoveries challenge our traditional classification of neurological and psychiatric diseases. New clinical paths are required to identify subgroups of neuropsychiatric disorders that are phenotypically distinct but pathogenically related and to pave the way for mechanism-based immune treatments.

Combined expertise from neurologists and psychiatrists will foster translation of these paths into clinical practice.

The aim of this Review is to highlight outstanding findings that have transformed our understanding of neuropsychiatric diseases and to suggest new diagnostic and therapeutic criteria for the emerging field of immunoneuropsychiatry.