Abstract
For more than 20 years, researchers have attempted to identify diagnostic and prognostic biomarkers for psychiatric disorders including schizophrenia, major (unipolar) depression, and bipolar disorder. Advocates of this research contend that identifying such biomarkers will aid in the diagnosis of these disorders, as well as the possible development of effective psychiatric medications to treat them. Currently, there are no diagnostic tests available. This is largely due to the multi-factorial nature of psychiatric disorders. Biomarker testing of individuals is also prohibitively expensive because significant expertise is required to conduct tests and follow-up counseling for the patient is often necessary. It is cautioned that widespread biomarker testing could lead to negative consequences such as discrimination in health insurance and employment, as well as selective abortion.
Highlights
For more than 20 years, researchers have attempted to identify diagnostic and prognostic biomarkers for psychiatric disorders including schizophrenia, major depression, and bipolar disorder
Correspondence There are no clinical laboratory tests to date that can be used by clinicians to diagnose patients with psychiatric disorders
Psychiatrists have to rely on the patient’s description of symptoms, mental status examinations, and clinical behavioral observations in order to make an accurate diagnosis in line with the diagnostic categories listed in the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) [1] or the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) [2]
Summary
The eventual use of biomarkers for psychiatric diagnosis will need to be implemented with caution and with full awareness of the costs involved. Compared to current measures of disease diagnosis, such as behavioral observation or questionnaires, the use of biomarkers is a more labor-intensive approach and requires a higher level of expertise. One needs to closely weigh the costs against the benefits because currently there are no reliable biomarkers that can consistently predict mental illness. In the rush toward developing etiological screening tools, it must be remembered that the patient is at the heart of the medical profession, not their DNA. Any new diagnostic tools should confer a significant benefit to patients and not promote confusion, discrimination, or stigma
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