Ethical considerations for precision psychiatry: A roadmap for research and clinical practice

Paolo Fusar-Poli¹, Mirko Manchia², Nikolaos Koutsouleris³, David Leslie⁴, Christiane Woopen⁵, Monica E Calkins⁶, Michael Dunn⁷, Christophe Le Tourneau⁸, Miia Mannikko⁹, Tineke Mollema¹⁰, Dominic Oliver¹¹, Marcella Rietschel¹², Eva Z Reininghaus¹³, Alessio Squassina¹⁴, Lucia Valmaggia¹⁵, Lars Vedel Kessing¹⁶, Eduard Vieta¹⁷, Christoph U Correll¹⁸, Celso Arango¹⁹, Ole A Andreassen²⁰; PSMD EBRA cluster (annex 1)

Affiliations

¹ Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. Electronic address: paolo.fusar-poli@kcl.ac.uk.
² Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada.
³ Section for Neurodiagnostic Applications, Ludwig-Maximilian-University, Munich.
⁴ Ethics Theme Lead, The Alan Turing Institute.
⁵ Center for Life Ethics, University of Bonn.
⁶ Neurodevelopment and Psychosis Section and Lifespan Brain Institute of Penn/CHOP, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, USA.
⁷ Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore.
⁸ Institut Curie, Department of Drug Development and Innovation (D3i), INSERM U900 Research unit, Paris-Saclay University, France.
⁹ European Federation of Associations of Families of People with Mental Illness (EUFAMI), Leuven, Belgium.
¹⁰ Global Alliance of Mental Illness Advocacy Networks-Europe (GAMIAN), Brussels, Belgium.
¹¹ Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
¹² Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
¹³ Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria.
¹⁴ Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Italy.
¹⁵ South London and Maudsley NHS Foundation Trust, London, UK; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychiatry, KU Leuven, Belgium.
¹⁶ Copenhagen Affective disorder Research Center (CADIC), Psychiatric Center Copenhagen, Denmark; Department of clinical Medicine, University of Copenhagen, Denmark.
¹⁷ Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
¹⁸ The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience; The Feinstein Institutes for Medical Research, Manhasset, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
¹⁹ Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Gregorio Marañón; Health Research Institute (IiGSM), School of Medicine, Universidad Complutense de Madrid; Biomedical Research Center for Mental Health (CIBERSAM), Madrid, Spain.
²⁰ NORMENT, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.

PMID: 36041245
DOI: 10.1016/j.euroneuro.2022.08.001

Free article

Review

Ethical considerations for precision psychiatry: A roadmap for research and clinical practice

Paolo Fusar-Poli et al. Eur Neuropsychopharmacol. 2022 Oct.

Free article

. 2022 Oct:63:17-34.

doi: 10.1016/j.euroneuro.2022.08.001. Epub 2022 Aug 27.

Authors

Affiliations

¹ Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. Electronic address: paolo.fusar-poli@kcl.ac.uk.
² Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada.
³ Section for Neurodiagnostic Applications, Ludwig-Maximilian-University, Munich.
⁴ Ethics Theme Lead, The Alan Turing Institute.
⁵ Center for Life Ethics, University of Bonn.
⁶ Neurodevelopment and Psychosis Section and Lifespan Brain Institute of Penn/CHOP, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, USA.
⁷ Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore.
⁸ Institut Curie, Department of Drug Development and Innovation (D3i), INSERM U900 Research unit, Paris-Saclay University, France.
⁹ European Federation of Associations of Families of People with Mental Illness (EUFAMI), Leuven, Belgium.
¹⁰ Global Alliance of Mental Illness Advocacy Networks-Europe (GAMIAN), Brussels, Belgium.
¹¹ Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
¹² Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
¹³ Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria.
¹⁴ Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Italy.
¹⁵ South London and Maudsley NHS Foundation Trust, London, UK; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychiatry, KU Leuven, Belgium.
¹⁶ Copenhagen Affective disorder Research Center (CADIC), Psychiatric Center Copenhagen, Denmark; Department of clinical Medicine, University of Copenhagen, Denmark.
¹⁷ Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
¹⁸ The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience; The Feinstein Institutes for Medical Research, Manhasset, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
¹⁹ Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Gregorio Marañón; Health Research Institute (IiGSM), School of Medicine, Universidad Complutense de Madrid; Biomedical Research Center for Mental Health (CIBERSAM), Madrid, Spain.
²⁰ NORMENT, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.

PMID: 36041245
DOI: 10.1016/j.euroneuro.2022.08.001

Abstract

Precision psychiatry is an emerging field with transformative opportunities for mental health. However, the use of clinical prediction models carries unprecedented ethical challenges, which must be addressed before accessing the potential benefits of precision psychiatry. This critical review covers multidisciplinary areas, including psychiatry, ethics, statistics and machine-learning, healthcare and academia, as well as input from people with lived experience of mental disorders, their family, and carers. We aimed to identify core ethical considerations for precision psychiatry and mitigate concerns by designing a roadmap for research and clinical practice. We identified priorities: learning from somatic medicine; identifying precision psychiatry use cases; enhancing transparency and generalizability; fostering implementation; promoting mental health literacy; communicating risk estimates; data protection and privacy; and fostering the equitable distribution of mental health care. We hope this blueprint will advance research and practice and enable people with mental health problems to benefit from precision psychiatry.

Keywords: Artificial intelligence; Bipolar disorders; Ethics; Precision medicine; Prevention; Psychosis.

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Conflict of interest statement

Competing interests The authors declare no competing interests.

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Ethical considerations for precision psychiatry: A roadmap for research and clinical practice

Affiliations

Ethical considerations for precision psychiatry: A roadmap for research and clinical practice

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical