Mental healthy problems are debilitating for the individual as they impact on their wellbeing and their ability to contribute at home and at work. There is also a substantial financial cost to governments. Beddington et al (2008) have highlighted the importance of a Nation’s mental capital and wellbeing.
Psychiatric disorders are disorders of neurocognition. Many psychiatric disorders, such as schizophrenia and attention deficit hyperactivity disorder, are of neurodevelopmental origin with an onset or prodromal stage in childhood or adolescence. Cognitive manifestations include: attentional biases, aberrant learning, memory impairments, dysfunctional reward systems; and lack of top down cognitive control by prefrontal cortex. Therefore biomarkers, including cognitive, genetic and neuroimaging ones, are needed for prevention, early detection and for assessing the efficacy of treatments. Screening at risk populations for common neuropsychiatric disorders in young and old people will facilitate prevention and early detection. Policy has also emphasized the importance of novel approaches to drug development for psychiatric disorders (Insel, Sahakian et al 2012). For instance, targets for treatment may become closely related to genetics and neurobiology (eg impulsivity, episodic memory) rather than diagnostic categories (eg ADHD, schizophrenia). A treatment which reduces impulsive behaviour, for example, might also do so whether an individual has a diagnosis of mania, ADHD or substance abuse, and treatment of episodic memory problems might prove useful for improving cognition and functional outcome in both mild Alzheimer’s disease and first-episode schizophrenia. It is now recognised that cognitive problems may impair performance of everyday functioning of patients with mental health disorders and prove the biggest barrier to rehabilitation and return to paid employment. Therefore cognitive enhancing drugs are needed to treat cognitive impairment associated with debilitating neuropsychiatric disorders. Such treatments will improve the quality of life and wellbeing for patients and their families and reduce the financial burden on society. Pharmacological treatments may prove most effective when used in combination with cognitive ones, such as cognitive behavioural therapy or cognitive training. Cognitive training and health care monitoring using novel technologies will be important for improving functional outcome and wellbeing.