Embracing complexity in psychiatry—from reductionistic to systems approaches

Abstract

The understanding and treatment of psychiatric disorders present unique challenges due to these conditions' multifaceted nature, comprising dynamic interactions between biological, psychological, social, and environmental factors. Traditional reductionistic approaches often simplify these conditions into linear cause-and-effect relationships, overlooking the complexity and interconnectedness inherent in psychiatric disorders. Advances in complex systems approaches provide a comprehensive framework to capture and quantify the non-linear and emergent properties of psychiatric disorders. This Personal View emphasises the importance of identifying rules for generative models that govern brain and behaviour over time, which might contribute to personalised assessments and interventions for psychiatric disorders. For instance, mood fluctuations in bipolar disorder can be understood through dynamical systems modelling, which identifies modifiable parameters, such as circadian disruption, that can be addressed through targeted therapies such as light therapy. Similarly, recognition of depression as an emergent property arising from complex interactions highlights the need for integrated treatment strategies that enhance adaptive reactions in the individual. A framework for quantifying multilevel interactions and network dynamics can help researchers and clinicians to understand the interplay between neural circuits, behaviours, and social contexts. Probabilistic models and self-organisation concepts contribute to building concrete dynamical systems models of mental disorders, facilitating early identification of risk states and promoting resilience through adaptive interventions delivered with optimal timing. Embracing these complex systems approaches in psychiatry could capture the true nature of psychiatric disorders as properties of a dynamic complex system and not the manifestation of any lesion or insult. This line of thinking might improve diagnosis and treatment, offering new hope for individuals affected by psychiatric conditions and paving the way for more effective, personalised mental health care.