Biomarkers in Psychiatry

Tina Notter

Accumulating evidence suggests that the pathophysiology or schizophrenia involves alterations in immune functions, both peripherally and centrally. Immunopsychiatric research has provided a number of candidate biomarkers that could aid estimating the risk of developing schizophrenia and/or predicting its clinical course or outcomes. This chapter summarizes the findings of immune dysfunctions along the clinical course of schizophrenia and discusses their potential value as predictive, trait or state biomarkers. Given the convergence of findings deriving from immunology, epidemiology, and genetics, the possibility of identifying immune-based biomarkers of schizophrenia seems realistic. Despite these promises, however, the field has realized that immune dysfunctions in schizophrenia may be as heterogeneous as the disorder itself. While challenging for psychiatric nosology, this heterogeneity offers the opportunity to define patient subgroups based on the presence or absence of distinct immune dysfunctions. This stratification may be clinically relevant for schizophrenic patients as it may help establishing personalized add-on therapies or preventive interventions with immunomodulating drugs.