[Perspectives opened up by the physiopathological understanding of psychiatric disorders]

Neuroimaging techniques have a rightful place in the field of psychiatry. They are essential for differential diagnosis, especially when the psychiatric presentation is atypical. Furthermore, they associate brain dysfunction with psychiatric disorders, but they cannot yet provide a definitive psychiatric diagnosis. However, from a therapeutic perspective, brain MRI is a very useful tool for neuronavigation techniques in combination with rTMS. From a neurobiological perspective, advances in genetics are allowing the development of genomic tests to guide antidepressant therapy and predict a diagnosis of bipolar disorder. In addition, psychedelics such as psilocybin offer promising alternatives for the treatment of depression. Similarly, ketamine, an antagonist of NMDA-type glutamatergic receptors, has shown efficacy in the management of suicidal crises and in the treatment of depressive disorders. Finally, antagonism of orexin receptors offer a new avenue for treating insomnia.