A Clinician's Perspective on Biomarkers.
Abstract
Psychiatrists and mental health professionals regularly perform various clinical tasks
(e.g., detection, differential diagnosis, prognostication, treatment selection and
implementation). How well they perform each of these tasks has a direct impact on
patient outcomes. Measurement-based care has brought greater precision to these tasks
and has improved outcomes. This article provides an overview of the types of biomeasures
and biomarkers, the clinical uses of biomarkers, and the challenges in their development
and clinical use. Although still in their infancy, biomarkers hold the promise of
bringing even greater precision and even better outcomes in mental health. Biomeasures
that could become biomarkers include genetic, proteomic, metabolomic, and immunologic
measures, as well as physiological, functional, and brain structural measures. Mechanistic
markers reflect and are based on the specific pathobiological processes that are involved
in the development of a clinically defined condition. Some clinically relevant biomarkers
may rely on this mechanistic understanding while others may not. Clinical biomarkers
serve three broadly defined goals. Diagnostic markers define what is wrong. Prognostic
markers define what will happen in the natural course of the condition, although they
may also predict the course of illness during treatment. Theranostic markers address
issues pertinent to treatment by defining whether, when, whom, and how to treat. Other
biomarkers may be used to monitor the overall effect of treatment regardless of the
therapeutic effects or to monitor the specific therapeutic effects of the intervention
on the disorder itself. Biomarkers can also be used to estimate susceptibility/risk
of developing the condition or the biological consequences of having had the disorder.
Type
Journal articlePermalink
https://hdl.handle.net/10161/24817Published Version (Please cite this version)
10.1176/appi.focus.20170044Publication Info
Rush, A John; & Ibrahim, Hicham M (2018). A Clinician's Perspective on Biomarkers. Focus (American Psychiatric Publishing), 16(2). pp. 124-134. 10.1176/appi.focus.20170044. Retrieved from https://hdl.handle.net/10161/24817.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
Collections
More Info
Show full item recordScholars@Duke
Augustus John Rush
Adjunct Professor in the Department of Psychiatry and Behavioral Sciences

Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy
Rights for Collection: Scholarly Articles
Works are deposited here by their authors, and represent their research and opinions, not that of Duke University. Some materials and descriptions may include offensive content. More info