McQuaid Robyn J
Carleton University, Department of Neuroscience, Ottawa, ON, Canada.
University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.
Brain Behav Immun Health. 2021 Jul 28;16:100303. doi: 10.1016/j.bbih.2021.100303. eCollection 2021 Oct.
Depression is a multifaceted disorder characterized by heterogeneous symptom profiles and high rates of comorbidity with other commonly occurring mental illnesses. Considering the burden of mental health disorders and the lack of efficacy of available treatments, there is a need for biomarkers to predict tailored or personalized treatments. However, identifying reliable biomarkers for complex mental illnesses, such as depression, anxiety and PTSD, has been challenging, likely owing to the heterogeneity, comorbidity and differences in experiences and histories of individuals. For these reasons, taking a transdiagnostic approach, which identifies biomarkers that map onto shared symptoms/constructs across disorders could be most effective for informing personalized or precision medicine approaches in psychiatry. Transdiagnostic features of anxiety, depression and anhedonia have been examined in relation to brain activity and connectivity patterns. Neuroendocrine and inflammatory markers, which are altered in depression and other comorbid illness, such as post-traumatic stress disorder (PTSD), might be useful in differentiating transdiagnostic symptom profiles as well as treatment responses. Ultimately, biomarker research that looks beyond diagnostic categories and embraces the complexity of individuals' lives and experiences might be more effective in moving towards precision medicine in psychiatry.
抑郁症是一种多方面的疾病，其特征是症状表现多样，且与其他常见精神疾病共病率高。考虑到精神健康障碍的负担以及现有治疗方法的疗效不佳，需要生物标志物来预测个性化或量身定制的治疗方案。然而，识别抑郁症、焦虑症和创伤后应激障碍等复杂精神疾病的可靠生物标志物一直具有挑战性，这可能是由于个体的异质性、共病情况以及经历和病史的差异所致。出于这些原因，采用跨诊断方法，即识别与不同疾病共有的症状/结构相关的生物标志物，可能对为精神病学中的个性化或精准医学方法提供信息最为有效。焦虑、抑郁和快感缺失的跨诊断特征已与大脑活动和连接模式相关联进行了研究。在抑郁症和其他共病疾病（如创伤后应激障碍）中发生改变的神经内分泌和炎症标志物，可能有助于区分跨诊断症状特征以及治疗反应。最终，超越诊断类别并考虑个体生活和经历复杂性的生物标志物研究，可能在推动精神病学精准医学发展方面更有效。
