Biomarkers for Psychiatry: The Journey from Fantasy to Fact, a Report of the 2013 CINP Think Tank
Elizabeth Scarr1, Mark J Millan2, Sabine Bahn2
1Department of Psychiatry, University of Melbourne, Victoria, Australia (Drs Scarr and Dean); The Molecular Psychiatry Laboratory, Florey Institute for Neuroscience and Mental Health, Victoria, Australia (Drs Scarr and Dean); Pole d'Innovation Thérapeutique en Neuropsychiatrie, Institut de Recherches Servier, Paris, France (Dr Millan); Cambridge Centre for Neuropsychiatric Research, University of Cambridge, UK (Dr Bahn); Pharma Research & Early Development, NORD, DTA, Hoffman - La Roche, Ltd., Basel, Switzerland (Dr Bertolino); School of Medicine, Basic Medical Sciences, Neuroscience and Sense Organs (DMBNOS), University of Bari, Italy (Dr Bertolino); Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany (Dr Turck); Institute of Psychiatry, Kings College London, London, UK (Dr Kapur); Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany (Dr Möller) elscarr@unimelb.edu.au.
Background:
A think tank sponsored by the Collegium Internationale Neuropsychopharmacologium (CINP) debated the status and prospects of biological markers for psychiatric disorders, focusing on schizophrenia and major depressive disorder.
Methods:
Discussions covered markers defining and predicting specific disorders or domains of dysfunction, as well as predicting and monitoring medication efficacy. Deliberations included clinically useful and viable biomarkers, why suitable markers are not available, and the need for tightly-controlled sample collection.
Results:
Different types of biomarkers, appropriate sensitivity, specificity, and broad-based exploitability were discussed. Whilst a number of candidates are in the discovery phases, all will require replication in larger, real-life cohorts. Clinical cost-effectiveness also needs to be established.
Conclusions:
Since a single measure is unlikely to suffice, multi-modal strategies look more promising, although they bring greater technical and implementation complexities. Identifying reproducible, robust biomarkers will probably require pre-competitive consortia to provide the resources needed to identify, validate, and develop the relevant clinical tests.
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