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Biomarker-driven stratified psychiatry: from stepped-care to matched-care in mental health

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Deciding between treatments in depression relies on trial-and-error following the stepped-care approach (escalating to more intensive treatments after treatment failures). Recent research is focused on biomarkers and precision psychiatry; however, we argue that stratified psychiatry could be a practical alternative for individuals with mental health disorders.

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Fig. 1: Stepped care versus stratified psychiatry.

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Authors and Affiliations

  1. Research Institute Brainclinics, Brainclinics Foundation, Nijmegen, The Netherlands

    Martijn Arns & Sebastian Olbrich

  2. Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands

    Martijn Arns & Alexander T. Sack

  3. Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zürich, Zurich, Switzerland

    Sebastian Olbrich

Authors
  1. Martijn Arns
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  2. Sebastian Olbrich
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  3. Alexander T. Sack
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Correspondence to Martijn Arns.

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Competing interests

M.A. holds equity/stock in neurocare and Sama Therapeutics, serves as consultant to Synaeda PMC, Sama Therapeutics and Roche, and is named inventor on patents and intellectual property but receives no royalties; Brainclinics Foundation received equipment support from Deymed and MagVenture. A.T.S. is scientific advisor of PlatoScience and Alpha Brain Technologies and CEO of Neurowear Medical. B.V. received equipment support from MagVenture, MagStim and Deymed, and is director of the International Clinical TMS Certification Course (www.tmscourse.eu). S.O. is co-founder of DeepPsy, a deep learning-based application for the prediction of treatment response in depression.

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Nature Mental Health thanks Brisa S. Fernandes, Jeremy Hall, Michael Moutoussis and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Arns, M., Olbrich, S. & Sack, A.T. Biomarker-driven stratified psychiatry: from stepped-care to matched-care in mental health. Nat. Mental Health 1, 917–919 (2023). https://doi.org/10.1038/s44220-023-00156-3

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