Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

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.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Stepped care versus stratified psychiatry.


  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 (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. (2023).

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Martijn Arns.

Ethics declarations

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 ( S.O. is co-founder of DeepPsy, a deep learning-based application for the prediction of treatment response in depression.

Peer review

Peer review information

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.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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).

Download citation

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing