Leo Sher, M.D.

Today, we publish an interview with an eminent European psychiatrist, Dr. Marco Sarchiapone.

Marco Sarchiapone, M.D. is Professor of Psychiatry, University of Molise, Campobasso, Italy. Dr. Sarchiapone is also Chair of the Section on Suicidology and Suicide Prevention, European Psychiatric Association; Co-chair of the World Federation of Societies of Biological Psychiatry Task Force, “Suicide: Biological Markers” and the Editor of “Suicidology Online.”

Leo Sher: What is the most important issue in contemporary psychiatry?

Marco Sarchiapone: I believe that the most important upcoming issues in psychiatry are more than one, but if I had to choose only one I’d say it would be the correct integration of biological, psychological, and social components (not psychosocial, like often tends to happen) which are always, even though in various degrees, participating to the genesis of psychological pathologies. This distinction, which lays its roots in the “Structuralism” of the philosopher Brentano, even though it has undoubtedly contributed to a better understanding of psychic phenomena, it has often been too harsh. Nowadays though, times are ripe to begin a true process of integration of the various concepts acquired in each of these fields, to the patients’ advantage who can now take advantage of more effective and tailored treatments.

Leo Sher: How do you see the future of psychiatry?

Marco Sarchiapone: The future of psychiatry, in my opinion, is made up of another process of integration: that is the challenge in what could synthetically be defined as the “bridging of the brain with the rest of the body”. In other words to consider the individual as a complex unit rather than the sum of single systems and apparata. It is blatant that the connections between different systems and apparata are neither mono nor bi-directional, but rather multidirectional and closely related among each other. Whenever one of these systems is stimulated the other ones too are “activated” participating in reaching the objective meanwhile sending “conditioning” feedback to the brain. Due to this, the traditional modeling will have to be replaced by different, more complex ones, that will be able to tackle the significant mole of data involved (e.g. mathematical models like those applied to chaos theory, fractal theory, etc).

Another consideration I would like to make concerning the future, including that of psychiatry as well, is dedicated to the power of reasoning that has allowed, and still allows, the supremacy of the human being as “dominant species” of this planet; understanding the aetiopathogenetic mechanisms of autism and dementia, which undermine the birth and determine the end of the cognitive process, will lead to a giant leap forward in the field of psychiatry.

Leo Sher: What needs to be done to reduce suicide rates in Italy and around the world?

Marco Sarchiapone: Suicide is such a complex and multifactorial phenomenon that is impossible to propose, given the current state of the art, a specific model of universal valence to reduce its rate. Despite this, following “general” principles that can be resumed in reducing risk factors and allow a better deployment of protective components that only recently have started to be taken into serious consideration is something that needs to be done. A good promotion of mental health will contribute to a reduction of the rate of this sad (maybe, the saddest) human phenomenon.

It is strikingly peculiar the fact that despite the worldwide efforts the rate of suicide hasn’t reduced proportionally like it happens in other pathologies. Maybe the reason for this resides in the fact that, like Camus would put it, suicide is such a complex and intrinsically specific of the Human Being that, on top of the implementation of more resources, it is mandatory to also adopt significantly more complex strategies that incorporate a synergic and realistic exploitation of all the inputs that the other scientific disciplines allow to use.