Finally, given the multiple mechanisms underlying psychiatric symptoms and the many considerations relevant to treatment decisions (which require a complex assessment of a range of factors, including understanding the function of symptoms, their social context, the risks versus benefits of treatment and patient access and preferences for treatment), a neurocircuit approach as we propose here may not be any simpler or more scientifically tractable than DSM defined disorders or other constructs. For example, SSRIs, whose effects impact on several of these circuits, at high doses are a remarkably useful intervention in OCD across different phenotypes and easier for a clinician to remember than having to target several different putative clinical profiles of the condition [191]. There is also the issue of how to identify clinical profiles and underlying neurocircuit alterations in individual patients, which would require the development of validated assessment protocols with established sensitivity and specificity.
