Testing Psychosis Phenotypes From Bipolar-Schizophrenia Network for Intermediate Phenotypes for Clinical Application: Biotype Characteristics and Targets
Testing Psychosis Phenotypes From Bipolar-Schizophrenia Network for Intermediate Phenotypes for Clinical Application: Biotype Characteristics and Targets
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DOI：
10.1016/j.bpsc.2020.03.011
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发表时间：
2020-08-01
影响因子：
5.9
通讯作者：
Tamminga, Carol A.
中科院分区：
文献类型：
--
作者：
Clementz, Brett A.;Trotti, Rebekah L.;Tamminga, Carol A.
背景：精神病学渴望从分子角度理解其疾病，并利用这些知识实现精准医学。支持精神病维度的此类目标的研究在一定程度上因仅使用现象学来估计疾病实体而受到损害。为此，我们是精神病深度表型分析方法的支持者，使用计算策略来发现信息最丰富的表型指纹，作为揭示精神病机制的有前途的策略。方法： 为此，双相精神分裂症中间表型网络 (B-SNIP) 使用生物标志物来识别具有可复制生物标志物特征的不同精神病亚型。虽然我们已经介绍了这些实体的相关性，但它们在临床实践中的潜在效用尚未得到证实。 结果：在这里，我们对表征生物型的临床特征进行了分析。我们发现生物型具有独特且明确的临床特征，可用作临床和研究环境中的初始筛选。这些临床特征的差异似乎与生物型生物标志物谱一致，表明生物学特征和临床表现之间的联系。与生物型相关的临床特征与与 DSM 诊断相关的临床特征不同，表明生物型和 DSM 综合征并不是多余的，并且可能会产生不同的治疗预测。我们重点介绍 3 个基于生物型的预测，这些预测源自个体生物标志物特征，无法从 DSM 精神病综合征中获得。结论：未来，生物型可能被证明可用于针对不同的分子、回路、认知和心理社会疗法，以改善功能结果。
BACKGROUND: Psychiatry aspires to the molecular understanding of its disorders and, with that knowledge, to precision medicine. Research supporting such goals in the dimension of psychosis has been compromised, in part, by using phenomenology alone to estimate disease entities. To this end, we are proponents of a deep phenotyping approach in psychosis, using computational strategies to discover the most informative phenotypic fingerprint as a promising strategy to uncover mechanisms in psychosis.METHODS: Doing this, the Bipolar-Schizophrenia Network for Intermediate Phenotypes (B-SNIP) has used biomarkers to identify distinct subtypes of psychosis with replicable biomarker characteristics. While we have presented these entities as relevant, their potential utility in clinical practice has not yet been demonstrated.RESULTS: Here we carried out an analysis of clinical features that characterize biotypes. We found that biotypes have unique and defining clinical characteristics that could be used as initial screens in the clinical and research settings. Differences in these clinical features appear to be consistent with biotype biomarker profiles, indicating a link between biological features and clinical presentation. Clinical features associated with biotypes differ from those associated with DSM diagnoses, indicating that biotypes and DSM syndromes are not redundant and are likely to yield different treatment predictions. We highlight 3 predictions based on biotype that are derived from individual biomarker features and cannot be obtained from DSM psychosis syndromes.CONCLUSIONS: In the future, biotypes may prove to be useful for targeting distinct molecular, circuit, cognitive, and psychosocial therapies for improved functional outcomes.