Kuan-Pin Su, M.D, Ph.D.
Chair of Scientific Commitee
Vice Dean of College of Medicine, China Medical University (CMU), Taichung, TAIWAN
Professor & Director of Mind-Body Interface Laboratory (MBI-Lab)
Honorary Faculty of Institute of Psychiatry-King's College London UK
The increasing global burden of major brain disorders calls for the development of novel approaches to tackle the challenge of unmet needs in prevention, diagnosis, and treatment. The awareness of the importance of brain research is exemplified by ambitious brain projects initiated in the United States (U.S. Brain Initiative), Europe (Human Brain Project), and Japan (Brain/MINDS). We cannot deny that vast investments have led to substantial improvements in scientific understanding and patient care in psychiatry. However, many more gains are possible if the potential waste and inefficiencies among biomedical research can be faced.
Firstly, current psychiatric diagnostic systems may be realistically feasible for clinical practitioners, but it is no longer sufficient for biomedical research of brain disorders. Due to clinical heterogeneity and etiological complexity based on current diagnostic systems, all the biomarkers or treatments only have limited effect sizes, and it is very easy to miss the small signals in human studies. For example, based on extensive supportive evidence of epidemiological, case-controlled, and pre-clinical studies, the use of omega-3 (n-3) polyunsaturated fatty acids (PUFAs) seem to be the most promising nutritional interventions for depression. However, clinical trials and meta-analyses revealed inconsistent results mainly because of common clinical trials’ pitfalls, which happen rarely in high-quality clinical trials conducted by pharmaceutical companies. Many more “non-patentable” “Eastern” treatments promising in pre-clinical studies (e.g. dietary therapy) or in clinical practice (e.g. acupuncture, mindfulness, and lifestyle intervention) fail to demonstrate consistent benefits in clinical trials because of lack of sufficient resources and financial incentives to conduct large-scale, high-quality, clinical trials.
Secondly, there is a huge neglect about the fundamental diversity of ethnicity-specific differences in psychopathology and biology. For decades, people from the East all benefit from Western medicine and sciences. In psychiatry, we could not deny that all the concepts by which we applied for diagnosis and treatment now are almost originally from the West. The mainstream of diagnostic systems, pharmaceutical Research and Design (R&D), or practice guidelines has never been originally based on Eastern people. They work quite well, but we don’t know whether they would work better if they were tailored for the East from the beginning.
In my presentation, I will discuss some critical differences between different ethnic groups and demonstrate why we need more translational research focusing on patients and treatments from East Asia, including modifying the diagnostic systems based on pathoplastic psychopathology, improving the quality of clinical trials, establishing the systematic theories based on scientific understandings, and standardizing the delivery of treatments.
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