Association between fundus sex index and hypertension, diabetes mellitus, and smoking in the Kumejima study.

Ten years after the decade of the brain, Thomas R. Insel, then head of the National Institute of Mental Health, reflected on the enduring impact those years had on the field of psychiatry. According to Insel, the primary progress during the “decade of the brain” did not lie in specific research achievements but, rather, in the methodological advancements in biomedical research, the full potential of which would manifest in the subsequent years. Indeed, the emergence of precision psychiatry, capitalizing on these methodological advances, seems to validate his foresight (). In contrast, other medical domains, particularly pharmacogenomics for rare diseases and cancer, were quicker to harness technological advancements to enhance the prediction, prevention, diagnostics, and treatment of illnesses in an individualized manner (; ; ; ; ; ). However, precision psychiatry gained momentum a few years later with the initiation of the RDoC Project (). It is within this context that we encounter the initial mentions of the idea of ‘precision medicine for psychiatry’ and “precision psychiatry” (), accompanied by its first extensive conceptual discussion (). Subsequently, research on precision psychiatry has been featured in edited collections (e.g., ; ; ), across major psychiatric journals, and in specialized publications like (first issue 2017) or (first issue 2021). It is intriguing to note that not all domains within psychiatry have garnered equal attention in transitioning toward precision medicine. Although strides have been made in diagnostic enhancement through computational phenotyping (e.g., ) and promising research in genetically informed psychopharmacology (e.g., ), one fundamental aspect of psychiatric treatment remains relatively unexplored in theoretical discourse and has seen a limited number of empirical investigations: psychotherapy. To address this gap, particularly in theoretical discourse, we propose a conceptualization of “Precision Psychotherapy.” This endeavor aims to enrich the systematic exploration of the diverse sub-fields within precision medicine. We recognize that the significance of this undertaking extends beyond mere systematic exploration; it holds value in facilitating informed decision-making. Providing a conceptualization of precision psychiatry offers valuable guidance to researchers and stakeholders in medical research and services, aiding in non-trivial decision processes. For instance, it can inform decisions regarding which research to include in reviews within the field of precision psychotherapy or determine the type of research and practices worthy of funding in projects aimed at advancing the implementation and research of precision psychotherapy. Such decision-making necessitates criteria for distinguishing precision psychotherapy and its associated research.