Major Change Coming in Mental Health Diagnoses
Psychiatrists are considering incorporating biomarkers into mental health diagnoses, potentially revolutionizing how mental illnesses are diagnosed and treated.
The American Psychiatric Association has outlined ideas for incorporating biomarkers into future versions of its Diagnostic and Statistical Manual of Mental Disorders (DSM).
The DSM provides criteria for diagnoses and is used by clinicians assessing patients and by insurance companies deciding whether to cover care.
Currently, prescribing psychiatric medications can be unpredictable, with clinicians unable to forecast whether they will work for a particular patient. In a seminal early 2000s trial, about 30% of participants with depression saw symptoms disappear with their first antidepressant treatment.
Adding biomarkers to the DSM would be significant. Access to test results, along with symptoms, could streamline insurance coverage decisions and help clinicians make faster and more accurate diagnoses and treatment recommendations.
In depression, for example, about a quarter of patients have elevated levels of C-reactive protein that can be found through a blood test. Research shows that people with high levels of this protein seem to respond better when given drugs that alter dopamine levels in the brain, rather than using only SSRIs.
The APA included various ways psychiatric biomarkers could be used in the future, such as testing for brain activity, genetic profiles or immune markers associated with certain psychiatric conditions.
However, psychiatric biomarkers are not ready for widespread use yet. A coordinated, well-funded research effort is needed to achieve validation. Some researchers have raised concerns about potential discrimination.
Despite the challenges, the APA's embrace of biomarkers signals the beginning of a revolution in mental healthcare, acknowledging that current approaches need improvement.
