Biomarkers for military mental health: Insights, challenges, and future prospects

Abstract

Mental health is increasingly being recognized as both a leading cause of disability worldwide and an important area of opportunity for biological breakthroughs. A major limitation in the current diagnosis and management of severe psychiatric conditions is the exclusive reliance on subjective clinical information in the absence of available laboratory tests. A lack of objective biomarkers that reliably identify mental health disorders, and which could serve as targets for diagnosis, treatment response monitoring, and the development of novel therapeutics, remains a fundamental challenge of psychiatry today. Although clinical tests are well established in other areas of medicine, their development in psychiatry has been relatively slow. So far, no biomarkers or other risk markers are available to create profiles to enhance prediction and therapeutic selection in psychiatry. As novel ‘omics-based technologies – such as genomics, proteomics, and metabolomics – and advanced imaging modalities enable researchers to probe the molecular to systemic underpinnings of various disorders, opportunities arise to explore the biological basis for mental health and disease. It is anticipated that specific alterations in blood-based molecular biomarkers, such as DNA, RNA, protein, and metabolite levels, will lead to standardized tests to facilitate diagnosis as they reflect the underlying etiology and mechanisms of disease. They may also pave the way for earlier and more effective treatment and monitoring of patients. Ultimately, the coordinated effort of relevant civilian and military stakeholders – including researchers, physicians and funders – together with standardization initiatives, will be vital to overcoming existing challenges to advance personalized mental health care using sensitive and specific biomarkers.