In recognition of Mental Health Awareness Month, one of our co-founders, Dr. Jay Lombard, explored the reason for creating Genomind and the future of genetic testing.
A question that is frequently posed to me is why I co-founded Genomind. This question is really asking about the purpose and intent at the core of our company and our goals as they relate to the field of psychiatry. As a neurologist, I find that the most challenging disorders of the brain are those which we cannot quantify or measure. Unlike strokes or tumors, there is no assessment that allows us to discern the physical nature of psychiatric diseases. The unfortunate consequence of this gap means the frequent stigmatization of these disorders.
Comorbidity: respecting the mind and body
When I was still in academia, I had the opportunity to teach psychiatry and neurology residents. On rounds, we would be asked to consult on patients who had comorbidity - the co-occurrence of physical and psychiatric problems. This was invariably the norm, not the exception. For example, a patient with seizures would have significant depression, or a patient with a severe mood disorder would also have migraines, etc. I would implore my students, as well as myself, to have as much respect for the biological factors contributing to these disorders as a neurosurgeon would have when operating on a tumor. When he or she does so, they carefully map out the region of the brain affected, understanding what regions are diseased and require removal, while preserving the healthy brain areas.
The role of translational medicine in psychopharmacology
We are still a very long way away from accomplishing such surgical-like precision in psychiatry. While psychiatric conditions will always have both psychological and biological components, the challenge for the field is to map out those physical variables which we have the tools to favorably modify in some way. I am referring to the field of psychopharmacology- the area of medicine concerned with how certain medications can affect brain chemistry. These include drugs approved for depression, mood stabilizers and other pharmaceutical agents which are widely employed today.
As these agents continue to evolve, with more specificity regarding their biological activity within the brain as well as their potential side effects, there remains a significant gap as to when these drugs should be used or avoided. Thus, one of the benefits of genetics in psychiatry is to help fill this void. Genomind is devoted to an area of neuroscience called translational medicine. This undertaking involves bringing together some of the world’s best neuroscientists and key opinion leaders in genetics and psychiatry and asking a simple question; what research has emerged that can be applied in the here and now for patients? What have we learned about the role of genetics in psychiatry that is particularly applicable for individuals who may require medication as part of their treatment? Further, how does such data inform us about treatment options as well as enhance our fundamental understanding of the biological factors involved in these disorders?
Looking to the future of genetic testing
Perhaps the biggest challenges we have faced are the lingering misconceptions regarding the role of genetics in psychiatry. The first misconception is that genetic results are deterministic, rather than probabilistic. Genes are biological variables but we must always keep in mind that in regards to behavioral issues, one must take into account both psychosocial issues and physical variables. The more we understand about our brain, the more empowered we are to harness its plasticity and our ability to heal. What is most exciting is that we know a great deal more about the role of genetics in psychiatry then we did a decade ago, and what we will know ten years from now will likely dwarf what we know today. It is through the engagement of ideas from the bench to the bedside and the bedside to the bench that this field will continue to evolve, affording us a better selection of treatment options to overcome the stigma and therapeutic nihilism often surrounding mental illness.
-- Dr. Jay Lombard