Blog Posts

Towards a consensus roadmap for a new diagnostic framework for mental disorders (2024)

2/7/2025

Towards a consensus roadmap for a new diagnostic framework for mental disorders (2024)

Val's Take/Conjecture

It's been over a decade since the US National Institute of Mental Health said the DSM 5 lacked scientific validity.
Since then, researchers around the world have corroborated that concern and begun their own efforts to address it.
There are more and more entities and researchers around the world articulating the "crucial need" for a "biology-informed framework."
This has implications for Criminal Justice and State Disability Housing, Placement and Service provision.

Coming to Terms with the Criminal Justice System as the Disability Provider of Last Resort

Abstract

Current nosology claims to separate mental disorders into distinct categories that do not overlap with each other.

This nosological separation is not based on underlying pathophysiology but on convention-based clustering of qualitative symptoms of disorders which are typically measured subjectively.

Yet, clinical heterogeneity and diagnostic overlap in disease symptoms and dimensions within and across different diagnostic categories of mental disorders is huge.

While diagnostic categories provide the basis for general clinical management, they do not describe the underlying neurobiology that gives rise to individual symptomatic presentations.

The ability to incorporate neurobiology into the diagnostic framework and to stratify patients accordingly will be a critical step forward for the development of new treatments for mental disorders.

Furthermore, it will also allow physicians to provide patients with a better understanding of their illness's complexities and management.

To realize this ambition, a paradigm shift is needed to build an understanding of how neuropsychiatric conditions can be defined more precisely using quantitative (multimodal) biological processes and markers and thus to significantly improve treatment success.

The ECNP [European College of Neuropharmacology] New Frontiers Meeting 2024 set out to develop a consensus roadmap for building a new diagnostic framework for mental disorders by discussing its rationale, outlook, and consequences with all stakeholders involved.

This framework would instantiate a set of principles and procedures by which research could continuously improve precision diagnostics while moving away from traditional nosology. In this meeting report, the speakers' summaries from their presentations are combined to address three key elements for generating such a roadmap, namely:

* the application of innovative technologies,

*understanding the biology of mental illness, and

*translating biological understanding into new approaches.

In general, the meeting indicated a crucial need for a biology-informed framework to establish more precise diagnosis and treatment for mental disorders to facilitate bringing the right treatment to the right patient at the right time.

2025 Research: Neo-Natal Inflammation, Microglia, and Investigation of New Treatments

2/7/2025

2025 is bringing a continued focus on:

Neo-Natal Inflammation
Microglia (the Brain's Innate Immune Cells), and
More Investigation of New Treatments

Remimazolam attenuates lipopolysaccharide-induced neuroinflammation and cognitive dysfunction (2025)

Ginsenoside reprogramming microglia through the FGF/FGFR1 inhibits post traumatic stress disorder (2025)

Neonatal inflammation impairs developmentally-associated microglia and promotes a highly reactive microglial subset (2025)

Chronic Fatigue Syndrome & Neuro-developmental / Psychiatric Disorders

2/6/2025

Val's Take: IT TAKES A LOT OF TIME AND ENERGY to UNDERSTAND THESE DISORDERS, especially if they have not been easily resolved with current understandings.

What's left is pretty darn complicated --- Health Disorders such as:

Neuro-Developmental and Psychiatric Disorders
ME/CFS
Cancer
Autoimmune Diseases
Neuro-Degenerative Disorders
Neuro-Immune Disorders
Etc.

Most "Neuro-Developmental" and "Psychiatric" diagnoses at this point are conceptualized as NEURO-DEVELOPMENTAL, MULTI-SYSTEM DISORDERS in the Research.

How many People know that?
How many Clinicians know that?
How many Policymakers?

University of Michigan School of Medicine
Dr. Melvin McInnis

The Cells of People with Bipolar Disorder are Developmentally Different (2017)

Columbia Public Health
Dr. Mady Hornig

Scientists Discover Robust Evidence That Chronic Fatigue Syndrome (ME/CFS) Is a Biological Illness (2015)

Broken Battery

ME/CFS -- The Greatest Medical Scandal of the 21st Century (2024)

Many people with Neuro-Developmental & Psychiatric Disorders have issues with Burnout, Melt Downs & Shut Downs. BIO-ENERGETICS is turning out to be a big issue in Neuro-Developmental & Psychiatric Disorders.

In fact, some type of Mitochondrial Dysfunction and Fatigue is associated with many diseases and disorders.

A lot of people in the Homeless Population get tagged with being "LAZY" or "UNMOTIVATED," and I think what is going on is much more complicated.

Astrocytes in Depression and a complicated biological universe for criminal justice

2/5/2025

Various types of GLIAL CELLS in both the Central Nervous System (CNS) and the Peripheral Nervous System (PNS) seem critical in Neuro-Developmental Disorders, Psychiatric Disorders, Neuro-Degenerative Disorders as well as other Diseases and Disorders.

This is exceedingly complicated in 2025.

What happens if we have a Criminal Justice System that is unable to deal honestly and effectively with this COMPLEXITY?

Well, you might live in the most incarcerated country in the world that still has significant safety problems.

NeuroLingo

Liam Anuj O'Leary
McGill University (Canada)
McGill Group for Suicide Studies

Fewer astrocytes in depression

Astrocytic Neuroligin-3 influences gene expression and social behavior, but is dispensable for synapse number (2025)

Widespread Decrease of Cerebral Vimentin-Immunoreactive Astrocytes in Depressed Suicides (2021)

Microglia, Neuro-Degenerative Diseases & Neuro-Developmental Disorders

1/31/2025

Dr. Melanie Capasso
DZNE, Bonn, Germany

Overactive Microglia in the Aging Brain

"Not only neurons exist in the brain, but also immune cells, the microglia. These microglia form our 'brain security' and protect the brain from pathogens.

"But with increasing age, the microglia, which are supposed to protect the brain, permanently raise the alarm and become chronically active.

"Inflammation occurs: this is an excessive immune reaction. The microglia turn against the brain and then secrete pro-inflammatory substances themselves.

"This violent over-activation in turn contributes to the progression of a neurodegenerative disease such as Alzheimer's – because inflammatory processes in the brain accelerate neurodegeneration, i.e. the death of neurons."

Lior Brimberg
Feinstein Institute for Medical Research

Captopril Reduces Microglial Activation in Autism and Improves Social Behavior

"As the primary brain immune cells, microglia are critical for maintaining a healthy brain and are recognized as important sculptors of neuronal development.

"Exposure in utero to maternal brain reactive antibodies may perturb microglia programing leading to neurodevelopmental disorder."

MiCROGLIA & Substance Use

1/25/2025

Val's Take/Conjecture

Neuro-Developmental Disorders and Substance Use Issues are very prevalent in the Criminal Justice System and have challenged reform efforts.
My big mantra has been --- we need A PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE.
We need the updated understandings and treatments to fully make that a reality.
That is what the researchers are giving us.
Further, many of our current treatments are helping people.

Microglia NLRP3 Inflammasome and Neuroimmune Signaling in Substance Use Disorders. (2023)

"During the last decade,
substance use disorders (SUDs) have been increasingly recognized as neuroinflammation-related brain diseases.

...Recently, inflammasome-mediated signaling has been identified as playing critical roles in the microglia activation …"

Glial mechanisms underlying substance use disorders.
(2019)

"Although there is an extensive body of literature examining the neuronal mechanisms of substance use disorders, effective therapies remain elusive.

"Glia, particularly microglia and astrocytes, have an emerging and meaningful role in a variety of proces …"

New study shows adults with Autism Need More Support

1/24/2025

Val's Take: First, I think Taylor Heaton does such important work and she reaches so many people on YouTube.

I do want to say that the increase in Neuro-Developmental & Psychiatric Diagnoses is in part AWARENESS, but it's not just that.

Further, there is a great need for INTEGRATIVE THINKING to address the wicked problems of Giftedness/Sensory Processing Differences and Emotional Dysregulation in Neuro-Developmental & Psychiatric Disorders.

Additionally, Neuro-Developmental Disorders involve Developmental Inflammation and a kind of Premature Aging affecting multiple systems of the body resulting in Dysregulated Stress Responses and in many cases serious negative health consequences across the lifespan.

Taylor Heaton ---
Mom on the Spectrum
New Study Shows Adults with Autism Need More Support

Glial-Neuronal Networks & Neuro-Developmental & Psychiatric Disorders

1/20/2025

Val's Take: This video is from 14 years ago. The whole Glial, Neuron, Mental Health connection is "NEW" in a broad sense, but some researchers have been working on this for awhile --- and the number of researchers working on understanding the importance of Glial Cell Types in Neuro-Developmental and Psychiatric Disorders has increased exponentially over the last 5 years.

One of the points that Professor Hickie makes and I have tried to make although I'm not necessarily the best messenger for this --- we need to integrate Clinical and Research practice.

If you spend a lot of time trolling PubMed like I do --- there do seem to be big gulfs among the Researchers, the Clinicians and the Public with regard to basic understandings that greatly affect TREATMENT and POLICY.

Professor Ian Hickie, Brain Mind Centre (Australia)
Glial-Neuronal Networks: Dysfunction in Youth Mental Health

"Resilience," The Immune System & "Second Hits"

1/12/2025

Val's Take/Conjecture

"Maternal Immune Activation" involves the Immune System and occurs In Utero.
Among other things, Maternal Immune Activation impacts Adult Behavior.
So the first hit is "Maternal Immune Activation."
But during the course of our lives we have many and varied experiences of INFLAMMATION and STRESS.
It's a BRAVE NEW WORLD out there and some researchers are already proposing:
- "immunomodulatory" treatments for depression, and
- targeting microglia in treatment efforts.
The point I want to make is that when we talk about "RESILENCE" --- there are actually very complicated mechanics to that.

Additionally, UNPREDICTED CHRONIC STRESS seems to be an issue for mammals and us.

The Unpredictability of Neuro-Developmental and Psychiatric Disorders is taking a huge toll on Individuals, Families, Communities and Societies.
There is CONSCIOUS AWARENESS of the need for:
- Updated Paradigms
- Biomarkers, and
- Better Treatments that address Multi-System Disorders

Genes Participating in the Ensheathment of Neurons Are Affected by Postnatal Stress and Maternal Immune Activation in the Pituitary Gland (2023)

Fetal brain response to maternal inflammation requires microglia
(2024)

In utero infection and maternal inflammation can adversely impact fetal brain development.

Maternal systemic illness, even in the absence of direct fetal brain infection, is associated with an increased risk of neuropsychiatric disorders in affected offspring. . .

Using a rodent maternal immune activation (MIA) model in which polyinosinic:polycytidylic acid is injected into pregnant mice, we demonstrate long-lasting transcriptional changes in fetal microglia that persist into postnatal life.

We find that MIA induces widespread gene expression changes in neuronal and non-neuronal cells; importantly, these responses are abolished by selective genetic deletion of microglia, indicating that microglia are required for the transcriptional response of other cortical cell types to MIA.

These findings demonstrate that microglia play a crucial durable role in the fetal response to maternal inflammation, and should be explored as potential therapeutic cell targets.

The inflammatory underpinning of depression: An historical perspective (2024)

"Synthesizing insights from this extensive research, the review presents an integrative model of the biological foundations of inflammation-associated depression.

"It posits that we have reached a critical juncture where the translation of this knowledge into personalized immunomodulatory treatments for depression is not just possible, but imperative."