CINP Perspectives

September 2011

• Is biomarker discovery in psychiatric disorders being inhibited by a lack of standardised protocols and current diagnostic criteria?
  by Brian Dean

As in many areas of medicine there is a growing effort to identify useful biomarkers to aid the diagnoses and treatment of psychiatric disorders1.  Attempts are being made to discover biomarkers that may delineate psychiatric disorders according to existing diagnostic criteria2, to delineate sub-groups within existing syndrome level diagnostic criteria3 such as schizophrenia4 or to discover intermediate phenotypes within such diagnoses5.  In addition, biomarkers are been sort to provide some biological measure of treatment responsiveness in people with psychiatric disorders6-8.  Experience with disorders such as diabetes1 suggest this will be a long and involved undertaking and it must be questioned as to whether current efforts in psychiatry are being built on solid enough foundations to ensure successful outcomes.
In considering the utility of biomarkers in psychiatry a primary focus in the biological space has been to develop rapid blood test for the disorder9.  These could take the form of genetic testing, plasma or serum markers, changes in platelet and / or red blood cell function or gene expression in nucleated blood cells1.  In addition, again using experience from other disorders of the human CNS such as Alzheimer’s disease10, neuroimaging techniques may prove useful in disease diagnostics but these would be less convenient and more time consuming than blood based markers.
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