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Evidence-Based Umbrella Review of 162 Peripheral Biomarkers for Major Mental Disorders

journal contribution
posted on 2023-08-30, 17:11 authored by Andre F. Carvalho, Marco Solmi, Marcos Sanches, Myrela O. Machado, Brendon Stubbs, Olesya Ajnakina, Chelsea Sherman, Yue Ran Sun, Celina S. Liu, Andre R. Brunoni, Giorgio Pigato, Brisa S. Fernandes, Beatrice Bortolato, Muhammad I. Husain, Elena Dragioti, Joseph Firth, Theodore D. Cosco, Michael Maes, Michael Berk, Krista L. Lanctôt, Eduard Vieta, Diego A. Pizzagalli, Lee Smith, Paolo Fusar-Poli, Paul A. Kurdyak, Michele Fornaro, Jürgen Rehm, Nathan Herrmann
The literature on non-genetic peripheral biomarkers for major mental disorders is broad, with conflicting results. An umbrella review of meta-analyses of non-genetic peripheral biomarkers for Alzheimer’s disease, autism spectrum disorder, bipolar disorder (BD), major depressive disorder, and schizophrenia, including first-episode psychosis. We included meta-analyses that compared alterations in peripheral biomarkers between participants with mental disorders to controls (i.e., between-group meta-analyses) and that assessed biomarkers after treatment (i.e., within-group meta-analyses). Evidence for association was hierarchically graded using a priori defined criteria against several biases. The Assessment of Multiple Systematic Reviews (AMSTAR) instrument was used to investigate study quality. 1161 references were screened. 110 met inclusion criteria, relating to 359 meta-analytic estimates and 733,316 measurements, on 162 different biomarkers. Only two estimates met a priori defined criteria for convincing evidence (elevated awakening cortisol levels in euthymic BD participants relative to controls and decreased pyridoxal levels in participants with schizophrenia relative to controls). Of 42 estimates which met criteria for highly suggestive evidence only five biomarker aberrations occurred in more than one disorder. Only 15 meta-analyses had a power >0.8 to detect a small effect size, and most (81.9%) meta-analyses had high heterogeneity. Although some associations met criteria for either convincing or highly suggestive evidence, overall the vast literature of peripheral biomarkers for major mental disorders is affected by bias and is underpowered. No convincing evidence supported the existence of a trans-diagnostic biomarker. Adequately powered and methodologically sound future large collaborative studies are warranted.

History

Refereed

  • Yes

Volume

10

Page range

152

Publication title

Translational Psychiatry

ISSN

2158-3188

Publisher

Springer

File version

  • Accepted version

Language

  • eng

Legacy posted date

2020-05-04

Legacy creation date

2020-05-04

Legacy Faculty/School/Department

Faculty of Science & Engineering

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