The Columbia Precision Medicine Initiative provides a transformative opportunity in psychiatry to move beyond the traditional phenomenological disease classifications to target individual pathophysiology for therapeutic intervention.
Recognizing the power of precision medicine in behavioral brain disorders, a diagnostic clinic for precision neuropsychiatry at Columbia University Medical Center has been set up under the direction of Dr. Sander Markx in the Department of Psychiatry. The clinic includes a basic science laboratory led by Dr. Markx together with Dr. Bin Xu and a clinical facility for assessments, biomarker studies, and clinical trials.
The last several years have marked a turning point in our understanding of the genetics of behavioral brain disorders including traditionally thought of mental illness (like mood, anxiety, psychotic and eating disorders), intellectual disturbances (such as autism, learning disabilities, ADHD) and addictions (to alcohol, prescription, and recreational drugs). The increasing sophistication of genomic medicine has enabled us to reliably map genetic mutations that underlie debilitating psychiatric disorders of individual patients. The diagnostic clinic for precision neuropsychiatry is positioned to follow up on these findings, efficiently study the biologic consequences of these mutations and screen for novel treatments for psychiatric disorders for which there are currently few viable treatment options available, such as schizophrenia, autism spectrum disorder, and mood disorders.
The diagnostic clinic for precision psychiatry takes a pipeline approach, starting with extensive phenotypic characterization of patients suffering behavioral brain disorders, followed by a comprehensive assessment of the underlying genomic mutations. These genetic findings are then studied in different model systems to identify the disease mechanisms driving the disease phenotypes, along with developing applicable clinical biomarkers. In collaboration with several specialized labs at Columbia University Medical Center, high-throughput tools will be utilized to screen drugs and their capacity to restore normal neuronal function by targeting these disease mechanisms. As promising drugs are identified, the clinic will conduct targeted clinical trials for the specific patients who carry a given genetic variant. The first of these trials is already underway.