University of São Paulo School of Medicine, São Paulo, Brazil.
University of São Paulo School of Medicine, São Paulo, Brazil.
J Am Acad Child Adolesc Psychiatry. 2020 Aug;59(8):926-928. doi: 10.1016/j.jaac.2019.11.024. Epub 2020 Feb 6.
Although the term has been relatively ill defined in psychiatric research, "biomarker" is typically considered a measurable objective characteristic that can predict clinical outcomes such as risk, diagnosis, subgroups, severity, prognosis, and response to treatment. Among several fields of medicine, such as cardiology and oncology, biomarkers have been used to aid clinicians during the various stages of decision-making processes, advancing toward precision medicine and health in which care is tailored based on specific characteristics of individuals. However, that has not been the case for psychiatry until now. Despite the remarkable advancements in our understanding of the etiology and pathophysiology of mental disorders over the past decades, there is no well-validated biomarker incorporated into our clinical practice. We as psychiatrists still find ourselves establishing diagnoses, allocating individuals to treatment, and predicting response without inputs from the accumulated knowledge from neuroscience.
尽管“生物标志物”一词在精神医学研究中相对定义不明确，但它通常被认为是一种可测量的客观特征，可以预测临床结果，如风险、诊断、亚组、严重程度、预后以及对治疗的反应。在心血管和肿瘤学等多个医学领域，生物标志物已被用于帮助临床医生在决策过程的各个阶段做出决策，朝着精准医学和健康方向发展，根据个体的特定特征进行个性化护理。然而，直到现在，这在精神病学领域还没有实现。尽管在过去几十年中，我们对精神障碍的病因和病理生理学的理解取得了显著进展，但在我们的临床实践中没有纳入经过充分验证的生物标志物。我们精神病医生在做出诊断、为患者分配治疗方案以及预测治疗反应时，仍然没有从神经科学积累的知识中获得任何帮助。
