"Addictions, DSM-III, Brain Imaging & Psychedelics" with guest Charles F. Zorumski, MD скачать в хорошем качестве

"Addictions, DSM-III, Brain Imaging & Psychedelics" with guest Charles F. Zorumski, MD

GUEST: Dr. Charles Zorumski is the Samuel B. Guze Professor and immediate former Head of the Department of Psychiatry, and Professor of Neuroscience at Washington University School of Medicine (WUSM) in St. Louis. He also serves as Psychiatrist-in-Chief at Barnes-Jewish Hospital and Director of the Taylor Family Institute for Innovative Psychiatric Research. Summary In this compelling conversation, Dr. Mark Gold speaks with Dr. Charles Zorumski, a leading psychiatrist and neuroscientist at Washington University in St. Louis (WashU), about the institution’s transformative role in modern psychiatry. The discussion explores WashU’s pioneering contributions to psychiatric diagnosis, brain imaging, and treatment innovation. Beginning in the 1950s, WashU’s Department of Psychiatry—through the work of Eli Robbins, Sam Guze, and John Feighner—developed the first reliable diagnostic criteria, laying the foundation for the DSM-III. This marked a shift from subjective impressions to reproducible, criteria-based diagnoses, enabling rigorous research and clinical trials. The conversation also highlights WashU’s groundbreaking work in brain imaging, from early PET scans to advanced fMRI and precision functional mapping. These tools have helped link psychiatric symptoms to neural circuits, reinforcing the integration of neurobiology into psychiatric practice. WashU’s culture of mentorship has played a key role in fostering this interdisciplinary approach. Treatment innovation is another major theme. WashU continues to lead in the use of electroconvulsive therapy (ECT) for treatment-resistant conditions, and has been at the forefront of testing rapid-acting antidepressants like ketamine and nitrous oxide. The institution has also advanced neuromodulation techniques such as vagal nerve stimulation and transcranial magnetic stimulation (TMS). Dr. Zorumski discusses the translational success of neurosteroid research, particularly allopregnanolone, which has led to FDA-approved treatments for postpartum depression and epilepsy. The conversation concludes with emerging research on psychedelics like psilocybin, and how precision brain imaging is helping to uncover their therapeutic mechanisms. Overall, the dialogue underscores WashU’s enduring leadership in grounding psychiatric illness in biology, improving diagnostics, and advancing novel therapies through collaborative science. Key Insights 🏥 Medical Model Transformation: WashU revolutionized psychiatry by replacing psychodynamic impressions with a medically grounded, criteria-based diagnostic system. This shift enabled reproducible research and clinical trials, culminating in the DSM-III and reshaping global psychiatry. 🧩 Diagnosis as Prognosis: Sam Guze emphasized that diagnosis should predict illness course and guide treatment—an idea rooted in traditional medicine but novel in psychiatry. Longitudinal validation made psychiatric diagnoses more meaningful and clinically useful. 🧪 Imaging Bridges Biology and Diagnosis: WashU’s evolution from PET to fMRI and precision mapping has helped identify brain circuits underlying psychiatric symptoms. The challenge now is refining these tools for individual-level clinical use, akin to precision medicine in genetics. ⚡ Rapid-Acting Treatments Need Biomarkers: Traditional antidepressants take weeks to work. Rapid-acting agents like ketamine and nitrous oxide offer relief within hours but require new biomarkers and algorithms to guide personalized treatment. 💡 Neurosteroids from Bench to Bedside: Collaborative research at WashU led to the development of brexanolone and other neurosteroid-based treatments. This success story exemplifies how interdisciplinary science can yield transformative therapies. 🤝 Mentorship Fuels Innovation: WashU’s scientific culture, shaped by figures like Robbins and Guze, encouraged integration of neuroscience into psychiatry. This mentorship model continues to drive innovation in understanding and treating mental illness. 🍄 Psychedelics and Precision Imaging: Psilocybin studies at WashU use personalized connectome mapping to reveal how psychedelics alter brain connectivity. These insights may lead to individualized psychedelic therapies and deeper understanding of their mechanisms. #addiction #psychiatry #medicine #history #mentalhealth #psychedelics