摘要
Psychiatric disorders have traditionally been segregated from medical disorders in terms of drugs,treatment,insurance coverage and training of clinicians.This segregation is consistent with the long-standing observation that there are inherent differences between psychiatric disorders(diseases relating to thoughts,feelings and behavior)and medical disorders(diseases relating to physical processes).However,these differences are growing less distinct as we improve our understanding of the roles of epistasis and pleiotropy in medical genetics.Both psychiatric and medical disorders are predisposed in part by genetic variation,and psychiatric disorders tend to be comorbid with medical disorders.One hypothesis on this interaction posits that certain combinations of genetic variants(epistasis)influence psychiatric disorders due to their impact on the brain,but the associated genes are also expressed in other tissues so the same groups of variants influence medical disorders(pleiotropy).The observation that psychiatric and medical disorders may interact is not novel.Equally,both epistasis and pleiotropy are fundamental concepts in medical genetics.However,we are just beginning to understand how genetic variation can influence both psychiatric and medical disorders.In our recent work,we have discovered gene networks significantly associated with psychiatric and substance use disorders.Invariably,these networks are also significantly associated with medical disorders.Recognizing how genetic variation can influence both psychiatric and medical disorders will help us to understand the etiology of the individual and comorbid disease phenotypes,predict and minimize side effects in drug and other treatments,and help to reduce stigma associated with psychiatric disorders.
