Chapter 28.Precision Psychiatry

A revolution is under way in psychiatry. We are witnessing the emergence of precision medicine for psychiatry: “precision psychiatry.” Precision psychiatry is an integrative approach, one that pulls together the scientific foundations of the discipline and recent technological advances and directs them toward closing the gap between discovery and clinical translation. Today, although many effective treatments are available, finding the right treatment for the right patient is largely a matter of trial and error, and treatment selection is not linked to a precise understanding of an individual patient’s pathophysiology. In addition, efforts to prevent psychiatric conditions are in their infancy. The goals of precision psychiatry are threefold: precise classification (i.e., a specific understanding of the pathophysiology of each individual patient—what has gone wrong?), precise treatment planning (i.e., tailoring treatment plans in a personalized manner—how can we fix what has gone wrong?), and precise prevention (i.e., targeted and tailored prevention strategies—how can we keep things from going wrong?).