New scientific evidence suggests that mental illnesses may originate at a deep cellular level in the brain and are linked to disruptions in energy metabolism, not just chemical imbalances.

In a recent interview with Genomic Psychiatry, Harvard Medical School psychiatry professor and director of the Neuropsychiatric Research Program at McLean Hospital, Dr. Bruce M. Cohen, shares research findings that are reshaping global understanding of the causes and treatment of neuropsychiatric disorders. Drawing on nearly half a century of experience, he explains how modern discoveries could transform psychiatric practice worldwide.

Breakthroughs in Cellular Brain Research

Dr. Cohen’s laboratory was among the first to grow live brain cells from patient samples using induced pluripotent stem cell technology. This approach has revealed key disruptions in energy production and cell-to-cell communication in the brain—mechanisms that appear to underlie many mental illnesses affecting millions globally. With over 400 scientific publications and five patents, Dr. Cohen’s work points to new treatment strategies that could be significantly more precise and effective than traditional methods.

The Energetic Model of Mental Disorders

Dr. Cohen’s team has identified widespread failures in cellular energy metabolism in major psychiatric illnesses. These discoveries pave the way for targeted therapies that could help people across different regions and populations. Studies have shown that brain cells from individuals with schizophrenia, bipolar disorder, or Alzheimer’s disease have innate metabolic defects that can potentially be corrected before symptoms appear.

This energetic model challenges decades of traditional thinking based on neurotransmitter imbalances. Dr. Cohen emphasizes that the brain, more than any other organ, depends on finely tuned energy production and intercellular connections. Restoring these fundamental functions may help prevent or alleviate symptoms in vulnerable individuals, regardless of their background or environment.

Multidisciplinary Approaches and New Diagnostic Models

By integrating genomic analysis, advanced brain imaging, and cellular modeling, Dr. Cohen advocates for a multidisciplinary approach to studying mental health. This integration provides researchers with powerful tools to investigate complex brain disorders—especially affective, psychotic, and cognitive conditions found in diverse cultures and regions.

Instead of existing expert diagnostic systems that categorize people, Dr. Cohen supports the adoption of evidence-based dimensional approaches to describing patients. He believes that terms like “schizophrenia” should be replaced with scientifically grounded alternatives that reduce stigma and better reflect the complexity of these conditions. His proposed model focuses on symptom profiles rather than categorical labels, giving clinicians more nuanced tools for assessment and treatment planning.

Impact on Global Psychiatry

The dimensional approach, which emphasizes observable symptoms and disease progression rather than culturally defined categories, offers universal applicability while accounting for local differences and experiences. Such reforms could transform psychiatric practice internationally, improving diagnostic accuracy and treatment effectiveness across various healthcare systems.

Leadership and Innovation in Clinical Practice

Beyond the laboratory, Dr. Cohen has had a significant impact on the development of psychiatric care. As president and chief psychiatrist of McLean Hospital from 1997 to 2005, he led the institution out of financial crisis, creating more than 30 new programs that advanced clinical care and scientific research. His management philosophy focused on supporting staff and reducing bureaucracy—principles relevant to medical institutions worldwide.

Under his leadership, the hospital achieved record numbers in patient care, research funding, and educational programs. Notably, he established the Waverley Place Center—an innovative model supporting people with mental illnesses living in the community, where mission, not profit, is the priority.

Personal Journey and Values

The interview also reveals personal experiences that shaped Dr. Cohen’s scientific path. His early passion for physics and mathematics, along with meaningful encounters with psychiatric patients during his medical training, influenced his approach to research and patient care. He recalls his first patient, whose remarkable recovery through medication highlighted the power of psychiatry to restore lives.

Dr. Cohen speaks candidly about the anxiety and shyness that sometimes limited his professional opportunities. His honesty serves as encouragement for young scientists facing similar challenges, emphasizing that perseverance and dedication are key to scientific achievement.

Family holds a central place in his story. His father, a respected therapist, instilled in him a sense of medical duty and the importance of collaboration in science. Married for over 55 years, Dr. Cohen credits family support as the foundation of his long and productive career. This demonstrates that great scientific discoveries often grow from human connections and experiences that extend far beyond the laboratory.

Looking Ahead

Dr. Cohen is optimistic about the future of psychiatric research, while acknowledging existing social barriers. His current work focuses on identifying specific biological mechanisms that influence vulnerability to mental illness, with an emphasis on prevention. Since psychotic disorders typically emerge in adolescence and dementia develops later, he believes early interventions are becoming increasingly feasible.

The discussion highlights how new technologies—especially cellular reprogramming and genomic analysis—are expanding researchers’ ability to study the origins of mental illness. These methods, now more widely available thanks to international initiatives, are accelerating discoveries and paving the way for more effective treatments.

Dr. Cohen also stresses the need to encourage creativity and risk-taking in science, warning against the trend of funding only predictable or incremental research. He envisions the future scientific community as a global space where innovation can arise in any country or institution, free from hierarchies and restrictions. This philosophy aligns with the principles of open access, allowing important discoveries to spread without financial barriers and fostering a truly inclusive and collaborative model of scientific research.