Forum Lectures 2009
Nikolas Rose, BIOS, London School of Economics and Political Science
Promises and Perils of Biomarkers in Psychiatry
Friday, 13 November 2009, 16:00, Large Operon, EMBL Heidelberg
Biomarkers are a major new currency in psychiatry. While psychiatry long languished as a second-class citizen in science and medicine due to its contested disease classifications and inadequate aetiological explanations, some hope that the shift to biomarkers will legitimise psychiatric diagnoses by underpinning them with physiological evidence.
But many believe that biomarkers promise psychiatry far more than a basis for better diagnoses. In the current climate, which stresses early diagnosis and preventive and personalised intervention, it is hoped that biomarkers could assist prediction about the course of illness in a specific individual, the tailoring of treatment, and interventions that might overcome neurobiologically based deficits or anomalies in individual capacities whether at the start of life, in childhood interventions; or at the end, in conditions such as dementia.
In this talk I will consider these hopes, the reasons for such enthusiasm for biomarkers and the current state of the debate over the clinical and diagnostic role of biomarkers. I will suggest that, despite their promises, the attempt to identify biomarkers with diagnostic and clinical utility is fraught with technical problems. Further, using examples from childhood and old age, I will suggest that the use of biomarkers in psychiatric and related practices would have a number of problematic consequences, some of which are already evident.