Diagnostic profiling in clinical translational research — a European perspective

Abstract

BackgroundPersonalisation of treatment is a development in general medicine that may be of relevance for psychosomatic psychiatry as well. ObjectivesDiscuss how diagnostic profiling can contribute to clinical translational research in psychosomatic psychiatry. MethodsCritical review of current shortcomings and required strategies in clinical translational research. ResultsCurrent shortcomings in clinical mental health research concern 1) the validity and applicability of biological tests as biomarkers; 2) the diagnostic classifications and 3) the conceptualisation of mental disorder. Clinical psychosomatic research should broaden the current search for etiological mechanisms from the biological domain to include physical symptoms, cognitive function, psychological symptoms, their subjective appraisal by the patient, social factors such as experienced trauma, and resilience factors. The methodology of a profiling study is introduced, that would be particularly useful to describe profiles of patients associated with favourable or less favourable treatment outcome and to develop personalised treatments based upon that. These can then be evaluated in Randomised Clinical Trials (RCTs). ConclusionsDevelopment of new treatment strategies for mental disorders requires diagnostic procedures to provide clinicians and patients with tools, validated in humans, for tailoring treatment as much as possible to the particular problem, preference and profile of the patient, as a way of developing personalized treatment in psychiatry. Patients with Somatic Symptom Disorders (SSD) might be a group of particular interest to perform profling studies, as they present the highest phenomenological variety alongside the different domains. In this manner, innovative clinical translational research can pave the way with a contribution from psychosomatic psychiatry.