During the last years, an extraordinary effort has been made to identify biomarkers as potential tools for improving prevention, diagnosis, drug response and drug development in psychiatric disorders. Contrary to other diseases, mental illnesses are classified by diagnostic categories with a broad variety list of symptoms. Consequently, patients diagnosed from the same psychiatric illness present a great heterogeneity in their clinical presentation. This fact together with the incomplete knowledge of the neurochemical alterations underlying mental disorders, contribute to the limited efficacy of current pharmacological options. In this respect, the identification of biomarkers in psychiatry is becoming essential to facilitate diagnosis through the developing of markers that allow to stratify groups within the syndrome, which in turn may lead to more focused treatment options. In order to shed light on this issue, this review summarizes the concept and types of biomarkers including an operational definition for therapeutic development. Besides, the advances in this field were summarized and sorted into five categories, which include genetics, transcriptomics, proteomics, metabolomics, and epigenetics. While promising results were achieved, there is a lack of biomarker investigations especially related to treatment response to psychiatric conditions. This review includes a final conclusion remarking the future challenges required to reach the goal of developing valid, reliable and broadly-usable biomarkers for psychiatric disorders and their treatment. The identification of factors predicting treatment response will reduce trial-and-error switches of medications facilitating the discovery of new effective treatments, being a crucial step towards the establishment of greater personalized medicine.

中文翻译：

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精神病学中的生物标志物：概念，定义，类型和与临床现实的相关性。

在过去的几年中，人们做出了巨大的努力来确定生物标记物作为改善精神疾病的预防，诊断，药物反应和药物开发的潜在工具。与其他疾病相反，精神疾病按诊断类别进行分类，并具有多种症状。因此，从相同的精神疾病诊断出的患者在临床表现上存在很大的异质性。这一事实以及对精神障碍潜在的神经化学改变的不完全了解，导致当前药理学选择的疗效有限。在这方面，精神病学中生物标志物的识别对于通过开发允许对症候群进行分层的标志物来促进诊断变得至关重要。反过来可能会导致更集中的治疗选择。为了阐明这一问题，本综述总结了生物标志物的概念和类型，包括治疗性开发的操作定义。此外，该领域的研究进展被归纳为五个类别，包括遗传学，转录组学，蛋白质组学，代谢组学和表观遗传学。尽管取得了令人鼓舞的结果，但仍缺乏生物标志物研究，尤其是与对精神疾病的治疗反应有关的研究。这篇综述包括一个最终结论，指出了为开发有效，可靠和广泛使用的精神疾病及其治疗生物标志物这一目标所需要的未来挑战。