Identifying biological markers for improved precision medicine in psychiatry

Quinlan, Erin Burke; Banaschewski, Tobias; Barker, Gareth J.; Bokde, Arun L.W.; Bromberg, Uli; Büchel, Christian; Desrivières, Sylvane; Flor, Herta; Frouin, Vincent; Garavan, Hugh; Heinz, Andreas; Brühl, Rüdiger; Martinot, Jean‐Luc; Martinot, Marie‐Laure Paillère; Nees, Frauke; Papadopoulos, Dimitri; Paus, Tomáš; Poustka, Luise; Hohmann, Sarah; Smolka, Michael N.; Fröhner, Juliane H.; Walter, Henrik; Whelan, Robert; Schumann, Günter

doi:10.1038/s41380-019-0555-5

Cited by 52 publications

(43 citation statements)

References 70 publications

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“…Therefore, future replications should also be carried out outside of Europe, requiring careful harmonization of clinical tools and paradigms. As recently reported [ 150 ], the IMAGEN study has aligned itself with other global neuroimaging-genetics adolescent cohorts that will further enhance and clarify the work presented here.…”

Section: Discussionsupporting

confidence: 56%

The IMAGEN study: a decade of imaging genetics in adolescents

et al. 2020

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Imaging genetics offers the possibility of detecting associations between genotype and brain structure as well as function, with effect sizes potentially exceeding correlations between genotype and behavior. However, study results are often limited due to small sample sizes and methodological differences, thus reducing the reliability of findings. The IMAGEN cohort with 2000 young adolescents assessed from the age of 14 onwards tries to eliminate some of these limitations by offering a longitudinal approach and sufficient sample size for analyzing gene-environment interactions on brain structure and function. Here, we give a systematic review of IMAGEN publications since the start of the consortium. We then focus on the specific phenotype ‘drug use’ to illustrate the potential of the IMAGEN approach. We describe findings with respect to frontocortical, limbic and striatal brain volume, functional activation elicited by reward anticipation, behavioral inhibition, and affective faces, and their respective associations with drug intake. In addition to describing its strengths, we also discuss limitations of the IMAGEN study. Because of the longitudinal design and related attrition, analyses are underpowered for (epi-) genome-wide approaches due to the limited sample size. Estimating the generalizability of results requires replications in independent samples. However, such densely phenotyped longitudinal studies are still rare and alternative internal cross-validation methods (e.g., leave-one out, split-half) are also warranted. In conclusion, the IMAGEN cohort is a unique, very well characterized longitudinal sample, which helped to elucidate neurobiological mechanisms involved in complex behavior and offers the possibility to further disentangle genotype × phenotype interactions.

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Section: Discussionsupporting

confidence: 56%

The IMAGEN study: a decade of imaging genetics in adolescents

et al. 2020

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“…The difficulty is compounded by the lack of reliable biological markers in psychiatric evaluation, which makes it difficult to quantify any improvement after hospitalization, or in general after hospital or out-of-hospital pharmacotherapy and psychotherapy interventions [42]. The availability of biomarkers is going to increase in the near future as a great amount of research is already oriented in this direction [43].…”

Section: Discussionmentioning

confidence: 99%

Assessing and Improving the Quality in Mental Health Services

Samartzis

Talias

2019

IJERPH

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Background: The mental health of the population consists of the three essential pillars of quality of life, economy, and society. Mental health services take care of the prevention and treatment of mental disorders and through them maintain, improve, and restore the mental health of the population. The purpose of this study is to describe the methodology for qualitative and quantitative evaluation and improvement of the mental health service system. Methods: This is a narrative review study that searches the literature to provide criteria, indicators, and methodology for evaluating and improving the quality of mental health services and the related qualitative and quantitative indicators. The bibliography was searched in popular databases PubMed, Google Scholar, CINAHL, using the keywords "mental", "health", "quality", "indicators", alone or in combinations thereof. Results: Important quality indicators of mental health services have been collected and presented, and modified where appropriate. The definition of each indicator is presented here, alongside its method of calculation and importance. Each indicator belongs to one of the eight dimensions of quality assessment: (1) Suitability of services, (2) Accessibility of patients to services, (3) Acceptance of services by patients, (4) Ability of healthcare professionals to provide services, (5) Efficiency of health professionals and providers, (6) Continuity of service over time (ensuring therapeutic continuity), (7) Efficiency of health professionals and services, (8) Safety (for patients and for health professionals). Discussion/Conclusions: Accessibility and acceptability of service indicators are important for the attractiveness of services related to their use by the population. Profitability indicators are important economic indicators that affect the viability and sustainability of services, factors that are now taken into account in any health policy. All of the indicators mentioned are related to public health, affecting the quality of life, morbidity, mortality, and life expectancy, directly or indirectly. The systematic measurement and monitoring of indicators and the measurement and quantification of quality through them, are the basis for evidence-based health policy for improvement of the quality of mental health services.

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“…1a). Precision medicine does not only apply to pharmacological treatments, but also to psychological interventions for various chronic diseases [20]. Given that no prognostic factors, patient characteristics, and/or symptom characteristics for adults with subjective idiopathic tinnitus have been found to in uence the nal treatment outcomes, we reasoned that genetic information can be useful for the formulation of a more standardized cognitive/behavioral approach.…”

Section: Application Of the Genotype-based Algorithm Improves The Outmentioning

confidence: 99%

Genetically-informed behavioral and cognitive interventions may improve management of tinnitus

Gkouskou

Vlastos

Gazouli

et al. 2021

Preprint

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Introduction: Psychological and behavioral interventions, such as Cognitive Behavioral Treatment (CBT) and Tinnitus Retraining Therapy (TRT), are commonly applied either alone or in combination for the management of tinnitus but selection of the intervention model remains arbitrary. Herein we evaluated the hypothesis that genetic markers may guide the choice of tinnitus treatment towards improved therapeutic outcomes.Results: Patients with subjective idiopathic tinnitus were assigned to either a genetically-informed CBT or TRT intervention protocol based on the status of four single nucleotide polymorphisms (SNPs) of the dopamine and serotonin pathways, namely COMT rs4680, HTR2A rs7997012, HTR2A rs6311, and TPH2 rs4570625, that have been associated with behavioral or cognitive responses (Group A), or to a conventional approach (Group B) in which the choice of treatment was not directed by genotypic data. Tinnitus Handicap Index (THI) scores of perceived tinnitus severity were recorded at the initial and at the fourth session of treatment using appropriate questionnaires. A statistically significant reduction in the THI scores was evident only in the genotype-guided group A (t = 3.03, p = 0.01).Conclusion: Individualized incorporation of genetic information may improve the outcome of behavioral and cognitive interventions in tinnitus.

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Identifying biological markers for improved precision medicine in psychiatry

Cited by 52 publications

References 70 publications

The IMAGEN study: a decade of imaging genetics in adolescents

The IMAGEN study: a decade of imaging genetics in adolescents

Assessing and Improving the Quality in Mental Health Services

Genetically-informed behavioral and cognitive interventions may improve management of tinnitus

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