Integrated Approaches for Treatment-Resistant Psychiatric Disorders

Abstract

Integrated approaches for treatment-resistant psychiatric disorders can be an important issue in the perspective of clinical psychiatry. In the context of “next-generation treatments for psychiatric disorders,” the necessity for more precise and specific treatment approaches has been proposed. Hence, it has been suggested that treatment-resistant psychiatric disorders should be defined not by post hoc analyses but with clinical and biological markers. More specifically, the synergistic effect of interactions between specific genes and childhood trauma has been identified as a significant factor for defining treatment resistance in psychiatric disorders. Moreover, it has been consistently reported that antidepressant effects can interact with environmental factors. In addition, findings have supported the hypothetical conceptualization of an integrated approach to treatment-resistant psychiatric disorders. A new approach to psychotherapy, inspired by the reconsolidation-updating paradigm, which we refer to as the histone acetylation inhibitor-augmented psychotherapy (also called “plasticity-augmented psychotherapy”) is proposed. Hence, we speculate that the combination of psychotherapy and pharmacotherapy can be integrated from the viewpoint of epigenetic regulation and used to manage treatment-resistant psychiatric disorders in the future.