To the Editor Wallace claimed that neuropsychiatric diseases are not complex and proposed composite energy deficiency in the brain as a coherent theory for neuropsychiatric diseases.¹ Although we like simple theories, we respectfully disagree. If this were true, all individuals with mitochondrial disease would present with, and nota bene with, a wide variety of neuropsychiatric diseases. This is clearly not the case. Consider a mitochondrial disease like mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes syndrome, which is associated with depression or psychosis in 50% of cases but not so frequently with anxiety,² or POLG1 mutations, which are more frequently associated with psychosis than other psychopathology. Furthermore, such a brain composite energy deficiency should also result in a more 1-dimensional type of psychopathology that is at least not as diverse as in depression or schizophrenia, for example.

向编辑华莱士声称，神经精神疾病并不复杂，并提议将大脑中的复合能量缺乏作为神经精神疾病的连贯理论。¹尽管我们喜欢简单的理论，但我们还是不同意。如果这是真的，那么所有患有线粒体疾病的人都会出现各种各样的神经精神疾病，而并非只有一种。显然不是这样。考虑线粒体疾病，如线粒体脑病，乳酸性酸中毒和中风样发作综合征，这种疾病在50％的病例中与抑郁症或精神病有关，但并不常见于焦虑，²或POLG1突变，与其他精神病理学相比，更常与精神病相关。此外，这种大脑复合能量缺乏症还应导致精神病理学的更一维类型，例如至少不像抑郁症或精神分裂症那样多样化。