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What is computational psychiatry good for?

Published:September 09, 2022DOI:https://doi.org/10.1016/j.biopsych.2022.08.030
      It is rare in the field of biological psychiatry for hypotheses to be definitively refuted. Rather, topics of investigation drift into and out of fashion, often driven by the initial excitement of technological innovation, followed by the necessary corrective of nuanced or underwhelming clinical results. A well-known example of this is the association between depression and abnormal function of the HPA axis, as measured using the dexamethasone suppression test (DSST; 1). This observation led to a great deal of work investigating whether the association might help us identify useful subtypes of depression (
      • Schatzberg A.F.
      • Rothschild A.J.
      • Stahl J.B.
      • Bond T.C.
      • Rosenbaum A.H.
      • Lofgren S.B.
      • et al.
      The dexamethasone suppression test: identification of subtypes of depression.
      ) or predict treatment response (
      • Rush A.J.
      • Weissenburger J.
      • Vasavada N.
      • Orsulak P.J.
      • Fairchild C.J.
      Dexamethasone suppression test status does not predict differential response to nortriptyline versus amitriptyline.
      ). As it turned out, the specificity and predictive value of the DSST was not thought to be of a level that would be useful clinically and the topic has gradually moved out of the spotlight. We are left in the familiar position of knowing that non-suppression of the DSST is associated with depression, but not being sure how we can use this knowledge to help patients.
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