Biomarkers in Psychiatry: Concept, Definition, Types and Relevance to the Clinical Reality

Abstract

During the last years, an extraordinary effort has been made to identify biomarkers as potential tools for improving prevention, diagnosis, drug response and drug development in psychiatric disorders. Contrary to other diseases, mental illnesses are classified by diagnostic categories with a broad variety list of symptoms. Consequently, patients diagnosed from the same psychiatric illness present a great heterogeneity in their clinical presentation. This fact together with the incomplete knowledge of the neurochemical alterations underlying mental disorders, contribute to the limited efficacy of current pharmacological options. In this respect, the identification of biomarkers in psychiatry is becoming essential to facilitate diagnosis through the developing of markers that allow to stratify groups within the syndrome, which in turn may lead to more focused treatment options. In order to shed light on this issue, this review summarizes the concept and types of biomarkers including an operational definition for therapeutic development. Besides, the advances in this field were summarized and sorted into five categories, which include genetics, transcriptomics, proteomics, metabolomics, and epigenetics. While promising results were achieved, there is a lack of biomarker investigations especially related to treatment response to psychiatric conditions. This review includes a final conclusion remarking the future challenges required to reach the goal of developing valid, reliable and broadly-usable biomarkers for psychiatric disorders and their treatment. The identification of factors predicting treatment response will reduce trial-and-error switches of medications facilitating the discovery of new effective treatments, being a crucial step towards the establishment of greater personalized medicine.

Keywords: biomarkers; central biomarkers; lymphocytes; neuropsychiatry; peripheral biomarkers; personalized medicine.

Figure 1

Classification of biomarkers based on its main clinical application.

Figure 2

Aims and examples of the main types of biomarkers. SNPs, single nucleotide polymorphisms; CRP, c-reactive protein; IL-6, interleukin 6.

Figure 3

Integrative figure regarding the main samples used in the searching of biomarkers in neuropsychiatry: peripheral and central biomarkers. Created with BioRender.com.

Figure 4

Multi-omics approach for the discovery and validation of biomarkers to probe multidimensional phases of the disease. CGH, comparative genomic hybridization; Seq, sequencing; qRT-PCR, quantitative real time PCR; qPCR, semiquantitative real time PCR; HPLC, high performance liquid chromatography; NMR, nuclear magnetic resonance spectroscopy. Created with BioRender.com.