Schizophrenia and psychotic disorders in precision medicine and body-brain axis

The concept of precision medicine has emerged over the past decade: it emphasizes the utilization of human genomic data, demonstrating that molecular variations could predict therapeutic responses and clinical outcomes. This approach has been highly successful in oncology and other medical conditions. Nevertheless, given the heavy impact of environmental stressors and longitudinal life-course experiences on the molecular signatures that directly underlie the pathophysiology beyond genetic factors in neuropsychiatric and psychiatric disorders, post-genomic precision medicine is also highly warranted. Furthermore, the unique feature of the current diagnostic criteria for psychiatric disorders, which operationally maximize clinical reliability and utility by sacrificing validity, also exists as a potential barrier to establishing precision medicine. Thus, in this opinion paper, we discuss the current perspective of precision medicine on schizophrenia and psychotic disorders, including opportunities and challenges. This paper highlights important conceptual points when building protein-based platforms of a clinical cohort in the post-genomic era, which include the body-brain axis (or the brain-body relationships) and moonlighting proteins. Finally, we present the infrastructures of precision medicine in neuropsychiatric disorders at Johns Hopkins Medicine as a leading example.