“Now Is a Time for Optimism”: The Politics of Personalized Medicine in Mental Health Research

Abstract

Since the completion of the Human Genome Project, personalized medicine has become one of the most influential visions guiding medical research. This paper focuses on the politics of personalized medicine in psychiatry as a medical specialty, which has rarely been investigated by social science scholars. I examine how this vision is being sustained and even increasingly institutionalized within the mental health arena, even though related research has repeatedly failed. Based on a document analysis and expert interviews, this article identifies discursive strategies that help to sustain this vision and its promises: “complexity talk,” “extension,” and “boundary work.” These practices secure its plausibility, protect it from criticism, and maintain stakeholder support.

Patients’ and professionals’ views related to ethical issues in precision medicine: a mixed research synthesis

“…While 62 studies investigated professionals’ perceptions on PM, 45 publications reported on the views of patients. Among the HCPs, many oncologists [ 24 – 32 ] participated in the included studies, but also other medical specialists are represented: nephrologists [ 33 , 34 ], cardiologists [ 27 ], infectiologists [ 24 ], psychiatrists and clinical psychologists [ 35 ], pathologists [ 31 , 32 ], gastroenterology specialty trainees [ 36 , 37 ], geneticists and genetic counsellors [ 31 , 32 , 38 – 42 ], laboratory medicine professionals [ 43 ], pharmacists [ 44 , 45 ], critical care intensivists [ 38 ], physician assistants [ 46 ] and nurses [ 30 , 38 , 46 – 48 ]. From the outpatient sector, primary care providers [ 46 , 49 – 51 ] or family medicine providers [ 27 , 52 ] participated in some studies.…”

“…However, interpreting multiomics, clinical and lifestyle data becomes complicated by inadequate validation of biomarkers and insufficient evidence of clinical utility, which leads to clinical uncertainty [ 58 ]. Many clinicians and researchers are well aware of the limited [ 27 , 30 , 31 , 35 , 42 , 79 , 84 ] or ambiguous evidence [ 32 ] for the meaning of test results and possible treatment outcomes and regard the lack of practice guidelines as a barrier for the implementation of tests [ 27 , 79 ]. Some patients also doubt the accuracy of the tests [ 63 , 73 ] or the value of the test results to influence their fate [ 61 ].…”

Precision medicine and digital phenotyping: Digital medicine's way from more data to better health

“…As far as PM aims at incorporating all sorts of data for diagnosis and personalised treatments, DP seems to be the part of a personalisation which Rüppel describes being ‘increasingly rearticulated as ‘Big Data’ project’ (Prainsack, 2017; Rüppel, 2019: 593). DP and PM are both data-driven approaches aimed at understanding diseases and offering targeted treatments, only the data they use can vary from biological, genetic and genomic data to sensor-collected data from digital devices such as smartphones and wearables (DP).…”

“…Prainsack (2017: 21) calls the users of the devices ‘prosumers’, a combination of producers of data and consumers of information. Most of this data falls under the term big data, which has been described with properties as ‘volume, velocity, variety, exhaustive in scope, resolution, relational and flexible’ (Kitchin, 2014: 1; Rüppel, 2019). This means that it entails huge amounts of data with a high granularity.…”

Globalizing the Scientific Bandwagon: Trajectories of Precision Medicine in China and Brazil

“…Now, at the dawning of the genome era, it is critical that we encourage the same intensity towards deriving medical benefits from the genome that has characterized the historic effort to obtain the sequence. (Collins, Morgan, and Patrinos 2003, 290)After HGP’s conclusion, new promissory sciences emerged, such as pharmacogenomics, individualized medicine, and personalized medicine, all in hopes of unlocking the potential of genomics and “big data” to benefit the health and well-being of individuals around the world (Hedgecoe 2004; Fortun 2001; Rüppel 2019).…”