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Biomarker-driven stratified psychiatry: from stepped-care to matched-care in mental health

Deciding between treatments in depression relies on trial-and-error following the stepped-care approach (escalating to more intensive treatments after treatment failures). Recent research is focused on biomarkers and precision psychiatry; however, we argue that stratified psychiatry could be a practical alternative for individuals with mental health disorders.

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Fig. 1: Stepped care versus stratified psychiatry.

References

  1. Straten, A., van, Hill, J. J., Richards, D. A. & Cuijpers, P. Psychol. Med. 45, 231–246 (2014).

    Article  PubMed  Google Scholar 

  2. Arns, M., Dijk, H., van, Luykx, J. J., van Wingen, G. & Olbrich, S. Eur. Neuropsychopharm. 55, 14–19 (2022).

    Article  Google Scholar 

  3. Drysdale, A. T. et al. Nat. Med. 23, 28–38 (2017).

    Article  PubMed  Google Scholar 

  4. Dinga, R. et al. Neuroimage Clin 22, 101796 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  5. Voetterl, H. et al. Nat. Mental Health https://doi.org/10.1038/s44220-023-00160-7 (in press).

  6. van Dijk, H. et al. Sci. Data 9, 333 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  7. Cuijpers, P. et al. J. Affect Disorders 159, 118–126 (2014).

    Article  PubMed  Google Scholar 

  8. Saveanu, R. et al. J. Psychiatr. Res. 61, 1–12 (2015).

    Article  PubMed  Google Scholar 

  9. Anand, A. et al. New. Engl. J. Med. https://doi.org/10.1056/nejmoa2302399 (2023).

    Article  PubMed  Google Scholar 

  10. Fitzgerald, P. B. et al. Brain Stimul. 13, 145–152 (2019).

    Article  PubMed  Google Scholar 

Download references

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Correspondence to Martijn Arns.

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Competing interests

M.A. holds equity/stock in neurocare and Sama Therapeutics, serves as consultant to Synaeda PMC, Sama Therapeutics and Roche, and is named inventor on patents and intellectual property but receives no royalties; Brainclinics Foundation received equipment support from Deymed and MagVenture. A.T.S. is scientific advisor of PlatoScience and Alpha Brain Technologies and CEO of Neurowear Medical. B.V. received equipment support from MagVenture, MagStim and Deymed, and is director of the International Clinical TMS Certification Course (www.tmscourse.eu). S.O. is co-founder of DeepPsy, a deep learning-based application for the prediction of treatment response in depression.

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Nature Mental Health thanks Brisa S. Fernandes, Jeremy Hall, Michael Moutoussis and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Arns, M., Olbrich, S. & Sack, A.T. Biomarker-driven stratified psychiatry: from stepped-care to matched-care in mental health. Nat. Mental Health 1, 917–919 (2023). https://doi.org/10.1038/s44220-023-00156-3

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