Why has biological psychiatry been unable to identify biomarkers reliably associated with common psychiatric disorders such as schizophrenia and depression—despite three decades of intense research efforts? And why do pharmacological treatments only slightly outperform placebo in many controlled trials? Part of the explanation may be that almost all research studies analyze symptom sum scores instead of data on individual psychiatric symptoms. Another explanation is that heterogeneous conditions with blurry boundaries are essentialized and studied as discrete disease types. Here we provide an introduction to a new analytic framework (‘symptomics’) and summarize a number of studies that provide insights into the symptom structure underlying psychiatric diseases, with a focus on major depressive disorder. Our approach is guided by an evolutionary framework that may help to separate defects from defenses.
Eiko Fried studied Psychology at Ludwig-Maximilians-University in Munich, with a focus on clinical and evolutionary psychology. From 2010-2014, he worked on his Ph.D. titled “Covert Heterogeneity of Major Depressive Disorder: Depression Is More Than the Sum-Score of its Symptoms” at the Cluster Languages of Emotions at Freie Universität Berlin. During this time, he spent two semesters as a Visiting Scholar at the University of Michigan in Ann Arbor, closely collaborating with Randolph Nesse and Srijan Sen from the Departments of Psychology and Psychiatry. In 2014, he moved to Belgium and works in the research group of Quantitative Psychology at the University of Leuven as a postdoctoral research fellow. His main commitment is studying differences and causal associations among individual symptoms of mental health problems, with an interest in affective disorders, longitudinal multivariate statistical approaches, and network modeling.
Eiko Fried, Postdoctoral Research Fellow
University of Leuven
Psychiatric symptomics: a new perspective on mental disorders
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