Background Schizophrenia is a serious mental illness affecting approximately 20 million individuals globally.Both genetic and environmental factors contribute to the illness.If left undiagnosed and untreated,schizophr...Background Schizophrenia is a serious mental illness affecting approximately 20 million individuals globally.Both genetic and environmental factors contribute to the illness.If left undiagnosed and untreated,schizophrenia results in impaired social function,repeated hospital admissions,reduced quality of life and decreased life expectancy.Clinical diagnosis largely relies on subjective evidence,including self-reported experiences,and reported behavioural abnormalities followed by psychiatric evaluation.In addition,psychoses may occur along with other conditions,and the symptoms are often episodic and transient,posing a significant challenge to the precision of diagnosis.Therefore,objective,specific tests using biomarkers are urgently needed for differential diagnosis of schizophrenia in clinical practice.Aims We aimed to provide evidence-based and consensus-based recommendations,with a summary of laboratory measurements that could potentially be used as biomarkers for schizophrenia,and to discuss directions for future research.Methods We searched publications within the last 10 years with the following keywords:‘schizophrenia’,‘gene’,‘inflammation’,‘neurotransmitter’,‘protein marker’,‘gut microbiota’,‘pharmacogenomics’and‘biomarker’.A draft of the consensus was discussed and agreed on by all authors at a round table session.Results We summarised the characteristics of candidate diagnostic markers for schizophrenia,including genetic,inflammatory,neurotransmitter,peripheral protein,pharmacogenomic and gut microbiota markers.We also proposed a novel laboratory process for diagnosing schizophrenia in clinical practice based on the evidence summarised in this paper.Conclusions Further efforts are needed to identify schizophrenia-specific genetic and epigenetic markers for precise diagnosis,differential diagnosis and ethnicity-specific markers for the Chinese population.The development of novel laboratory techniques is making it possible to use these biomarkers clinically to diagnose disease.展开更多
基金This study was funded by Shanghai Natural Science fund Project under grant(20ZR1447700)The National Key Development Plan for Precision Medicine Research(2017YFC0910002)+4 种基金the hospital-level project of Shanghai Mental Health Center under grant(2020-YJ05)Special Fund for Clinical Research of Wu Jieping Medical Foundation(320675015232)the Hospital level project of Shanghai Mental Health Center(2016-YJ-09)Chinese medicine research project of Shanghai Health and Family Planning Commission(2018LP024)the characteristic discipline construction project of Shanghai Mental Health Center(2017-TSXK-07),China Public Health Alliance(first batch)(GWLM202014).
文摘Background Schizophrenia is a serious mental illness affecting approximately 20 million individuals globally.Both genetic and environmental factors contribute to the illness.If left undiagnosed and untreated,schizophrenia results in impaired social function,repeated hospital admissions,reduced quality of life and decreased life expectancy.Clinical diagnosis largely relies on subjective evidence,including self-reported experiences,and reported behavioural abnormalities followed by psychiatric evaluation.In addition,psychoses may occur along with other conditions,and the symptoms are often episodic and transient,posing a significant challenge to the precision of diagnosis.Therefore,objective,specific tests using biomarkers are urgently needed for differential diagnosis of schizophrenia in clinical practice.Aims We aimed to provide evidence-based and consensus-based recommendations,with a summary of laboratory measurements that could potentially be used as biomarkers for schizophrenia,and to discuss directions for future research.Methods We searched publications within the last 10 years with the following keywords:‘schizophrenia’,‘gene’,‘inflammation’,‘neurotransmitter’,‘protein marker’,‘gut microbiota’,‘pharmacogenomics’and‘biomarker’.A draft of the consensus was discussed and agreed on by all authors at a round table session.Results We summarised the characteristics of candidate diagnostic markers for schizophrenia,including genetic,inflammatory,neurotransmitter,peripheral protein,pharmacogenomic and gut microbiota markers.We also proposed a novel laboratory process for diagnosing schizophrenia in clinical practice based on the evidence summarised in this paper.Conclusions Further efforts are needed to identify schizophrenia-specific genetic and epigenetic markers for precise diagnosis,differential diagnosis and ethnicity-specific markers for the Chinese population.The development of novel laboratory techniques is making it possible to use these biomarkers clinically to diagnose disease.
