Comai Stefano, Manchia Mirko, Bosia Marta, Miola Alessandro, Poletti Sara, Benedetti Francesco, Nasini Sofia, Ferri Raffaele, Rujescu Dan, Leboyer Marion, Licinio Julio, Baune Bernhard T, Serretti Alessandro
Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy.
Department of Biomedical Sciences, University of Padua, Padua, Italy.
Int J Neuropsychopharmacol. 2025 May 9;28(5). doi: 10.1093/ijnp/pyaf025.
Precision psychiatry aims to improve routine clinical practice by integrating biological, clinical, and environmental data. Many studies have been performed in different areas of research on major depressive disorder, bipolar disorder, and schizophrenia. Neuroimaging and electroencephalography findings have identified potential circuit-level abnormalities predictive of treatment response. Protein biomarkers, including IL-2, S100B, and NfL, and the kynurenine pathway illustrate the role of immune and metabolic dysregulation. Circadian rhythm disturbances and the gut microbiome have also emerged as critical transdiagnostic contributors to psychiatric symptomatology and outcomes. Moreover, advances in genomic research and polygenic scores support the perspective of personalized risk stratification and medication selection. While challenges remain, such as data replication issues, prediction model accuracy, and scalability, the progress so far achieved underscores the potential of precision psychiatry in improving diagnostic accuracy and treatment effectiveness.
精准精神病学旨在通过整合生物学、临床和环境数据来改善常规临床实践。在重度抑郁症、双相情感障碍和精神分裂症的不同研究领域已经开展了许多研究。神经影像学和脑电图研究结果已经确定了预测治疗反应的潜在回路水平异常。包括白细胞介素-2、S100B和神经丝轻链蛋白在内的蛋白质生物标志物以及犬尿氨酸途径说明了免疫和代谢失调的作用。昼夜节律紊乱和肠道微生物群也已成为精神症状和预后的关键跨诊断因素。此外,基因组研究和多基因评分的进展支持了个性化风险分层和药物选择的观点。尽管仍然存在数据复制问题、预测模型准确性和可扩展性等挑战,但迄今为止取得的进展凸显了精准精神病学在提高诊断准确性和治疗效果方面的潜力。