Neurociências na Psiquiatria

Apesar da importância da compreensão dos circuitos cerebrais que influem no comportamento, existe ainda entre alguns profissionais da área de Saúde Mental uma certa resistência à mudança de paradigmas, sendo o estudo das Neurociências muitas vezes ainda considerado como excessivamente reducionista e restrito à esfera biológica.

Essa é uma visão que perdura até nossos dias:

… Although it is difficult to quantify precisely how much of NIMH’s funding supports brain-based research, understanding the biological basis of mental disorders is a high priority for NIMH. The research includes describing the molecules, cells, and neural circuits associated with complex behaviors and disorders as well as identifying the genomic factors associated with mental illnesses. Other federal funding agencies that support psychiatric research, including the National Institute on Drug Abuse and the National Institute on Child Health and Development, also emphasize research into the biological basis of mental illness.

Concerns

The backlash against this prioritization includes various arguments: that a focus on biological processes does not allow for free will and human agency, that a “neurocentric” view of the mind obscures the factors that shape our behavior and identities and risks undermining selfhood and personal responsibility, and that explaining the mind will always be a personal vision, not a scientific fact. (…)

(DICHTER, 2017.)

Antes de chegar à Teoria Psicanalítica, Sigismund (Sigmund) Schlomo Freud (1856-1939) visava um entendimento do comportamento humano integrado com a conhecimento neurológico — tarefa logo abandonada pela precariedade dos meios disponíveis na época. E agora que os meios permitem retomar essa linha de estudo torna-se necessário reconstruir pontes e encontrar uma linguagem e uma visão em comum.

Mesmo na forma parcial em que se deu esse diálogo, a Década do Cérebro (1990-1999) produziu muitos avanços de tratamento nos anos que se seguiram — como novos medicamentos e exames. Outras mudanças (como as sucessivas revisões do DSM, atualmente [2013] na 5a Edição) procuraram tornar os diagnósticos tão precisos quanto possíveis apesar do enfoque fenomenológico.

… In the short term the most important effect will be to encourage us to change the way we think about symptoms, focusing on proximal causes at the level of the brain and how these relate to psychological processes. Longer term, the hope is that by recognising mechanistic heterogeneity we will develop better classification systems, new approaches to intervention, and further tools to enable practitioners to choose the right treatment for the right individual.

(ROISER, 2015.)

E algo para pensar pelos próximos anos:

… Treating a person by focusing on a single receptor — in the case of prazosin, the alpha-1-adrenergic receptor subtype — is not a cold, dehumanizing abstraction. By looking beyond the phenomena of our inner experience to the Purkinje cells hard at work, we can create a pragmatic, nuts-and-bolts method of understanding and healing ourselves.

Plus, studies show that it works.

(BARRON, 2017.)


Bibliografia:

Andrews, Bernice; Brewin, Chris R. What did Freud get right? The Psychologist. 2000;13:605-7.
Barron, Daniel. Why Psychiatry Needs Neuroscience – Scientific American Blog Network. Scientific American. 25/04/2017. Acessado em janeiro de 2020.
Dichter, Gabriel L. Neuroscience Research for Psychiatry: The Brain and Behavior Link. Psychiatric Times. 18/07/2017. Acessado em março de 2021.
Panksepp, Jaak. Emotions as Viewed by Psychoanalysis and Neuroscience: An Exercise in Consilience. Neuropsychoanalysis. 1999;1(1):15-38.
Roiser, Jonathan. What has neuroscience ever done for us? The Psychologist. 2015;28:284-7.

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