A Dynamical Systems View of Psychiatric Disorders—Theory

作者：Marten Scheffer, Claudi Bockting, Denny Borsboom, Roshan Cools, Clara Delecroix, Jessica Hartmann, Kenneth S. Kendler, Ingrid van de Leemput, Han L. J. van der Maas, Egbert H. van Nes, Mark P. Mattson, Patrick D. McGorry, Barnaby Nelson · 发表于：JAMA Psychiatry · 年份：2024 · DOI：10.1001/jamapsychiatry.2024.0215 · 被引用次数：115 · 研究领域：Ecosystem dynamics and resilience、Climate Change and Health Impacts、Mental Health Research Topics

Importance: Psychiatric disorders may come and go with symptoms changing over a lifetime. This suggests the need for a paradigm shift in diagnosis and treatment. Here we present a fresh look inspired by dynamical systems theory. This theory is used widely to explain tipping points, cycles, and chaos in complex systems ranging from the climate to ecosystems. Observations: In the dynamical systems view, we propose the healthy state has a basin of attraction representing its resilience, while disorders are alternative attractors in which the system can become trapped. Rather than an immutable trait, resilience in this approach is a dynamical property. Recent work has demonstrated the universality of generic dynamical indicators of resilience that are now employed globally to monitor the risks of collapse of complex systems, such as tropical rainforests and tipping elements of the climate system. Other dynamical systems tools are used in ecology and climate science to infer causality from time series. Moreover, experiences in ecological restoration confirm the theoretical prediction that under some conditions, short interventions may invoke long-term success when they flip the system into an alternative basin of attraction. All this implies practical applications for psychiatry, as are discussed in part 2 of this article. Conclusions and Relevance: Work in the field of dynamical systems points to novel ways of inferring causality and quantifying resilience from time series. Those...