It is our honest opinion, patient readers, that the terrible problem of psychiatric disorder is on the point of being understood. On the same level that is, as illnesses such as measles, salmonella poisoning or scurvy. We think we know why, as we will explain below. But first to the work which gives us this hope, following as it does on our recent blog Psychiatric Disorders: is this a game changing moment? (LSS 18 12 2025)

Writing for the Guardian, David Shariatmadari reviews The Divided Mind by Edward Bullmore, a profoundly learned man who has devoted his life to investigating and alleviating the sufferings of those afflicted by mental disorders. It is a sweeping book, magisterially covering the disputes between the warring schools of thought and the decades of honest but often misguided attempts to effect cures and diagnoses. Too much to cover here, but we implore you to read the review, if not the book itself [1] [2] But, in a nutshell, it was this passage that truly excited us

(shariatmadari notes the remarkable process in understanding diseases like TB),then :

Schizophrenia may finally be on the cusp of that transformation – something truly momentous, given the puzzle this strange and brutal disease has posed for so long. As Bullmore carefully explains, advances in scanning, maths, genomics and immunology have piled up to give us a clearer understanding of the illness. It is probably caused by the abnormal development of brain networks in childhood and adolescence; this, the evidence suggests, happens under the influence of immune dysfunction, and the cause of that is variation in a broad range of genes, interacting in particular ways with the environment. Triggers can include infections, abuse, social stress or drug use.

And now for why we are so hopeful. We genuinely think that the work of Bullmore, and the scholars covered in the last blog, suggest that at last a new paradigm has formed. It has only been possible because of advances in disciplines like Immunology, complexity theory, genetics and catastrophe theory, and the technologies to support the vast data sets which this new learning requires. And with them should come the key concepts of robust diagnosis, risk factor, causal mechanism and, please, God-lasting ameliorations. We stress again that we do not belittle the heroic efforts of past investigators, who did not have the tools now available. New paradigms never make the old ones wrong. But they suddenly solve the problems the last one could not, and open the way to new lines of discovery which the old one could never have predicted. Einstein did not refute Newton, he simply went beyond. And it was the same for thinkers like Darwin, Kepler and Planck. It is our honest opinion that another such paradigm shift has arrived, gentle readers, We hope it will make the life of the world better too,

[1]https://www.theguardian.com/books/2025/dec/17/the-divided-mind-by-edward-bullmore-review-do-we-now-know-what-causes-schizophrenia?CMP=Share_iOSAp

[2]The Divided Mind: A New Way of Thinking About Mental Health by Edward Bullmore is published by New River (£20). To support the Guardian buy a copy at guardianbookshop.com. Delivery charges may apply.

#psychiatric disorder #health #immunology #genetics #complexity #disease #medicine

Why can we not do more to address psychiatric disorders? We have always regretted the lack of a robust model which links biological cause to behaviour (LSS 11 5 22;14 9 24 et al) Without this treatment can never achieve the same efficacy as it has for thousands of “physical” disorders such as infectious diseases, cancers or deficiency diseases.

Today It is our earnest hope that all this may be about to change. Read this Hidden links between psychiatric condition from Nature Briefing

DNA data from more than one million people suggests that the genetic risk factors linked to many psychiatric conditions fall into five clusters that cut across current diagnostic boundaries. For example, attention deficit hyperactivity disorder and autism, which are classified as separate conditions, both fall into the neurodevelopmental category. The findings hint that the fact that people tend to be diagnosed with multiple disorders at once is a reflection of shared underlying biology, and could help to create a more biologically based way of understanding psychiatric conditions.

Nature | 5 min read
Reference: Nature paper

If this work can be confirmed and extended, then it offers a tantalising possibility: this particular observable gene cluster is associated with this set of behaviours. And not another set of behaviours, which turn have their own identifiable gene cluster. Simple. Robust. Falsifiable. Empirical.  What’s more, the clusters seem to make a curious rule-of-thumb sense.  One for neurodevelopmental disorders such as ASD and ADHD. The second for internalising disorders such as anxiety, depression and so on. A third for compulsive ones like OCD and anorexia. A fourth for psychotic ones such as bipolar and schizophrenia   And a fifth for substance abuse disorders. Simply put , each cluster may have particular underlying neurological architecture. In which case the underlying mechanism may be discerned; and treatment found.

Now for the caveats. First of all, it’s early days and we need to see how the work holds up against existing diagnostic frameworks. Secondly, only a fool would rule out epigenetic and environmental contributions to psychiatric malfunction. As for the thought of any treatments based on the new findings-well, they have to be decades away if possible at all,.

And yet….to end on a personal note. Nothing is sadder, nothing so moves us as seeing yet another lost soul, another hopeless cry for help, in the face of a victim pf psychiatric disorder. And to know the terrible sufferings imposed upon themselves, their families, carers and the professionals who come up against them, which includes anyone from emergency service workers to housing professionals. And to know that nothing can be done, despite the whole of modern science and learning. But now, just maybe, we have a real game changer on our hands, There is something to pray for this Christmas.

#psychiatric disorders #mental health #medicine #neurology #health #society