science. They're being pioneered in America and the STAR*D trial is
something to do with this though I'm afraid I still don't know enough
about this significant study.
The hope is these markers will really bring a scientific approach to
diagnosing depression. There's the huge problem of undiagnoses mental
illnesses - people who have mental illness but survive without
treatment. To many doctors and psychiatrists this is a bad thing. It's
an untreated biomedical illness.
From my understanding of clinical depression it doesn't always have to
be associated with low mood. There are types of depression identified as
depression without low mood but I forget the name. The diagnostic
cluster has low mood as one of the 8 or 9 symptoms but low mood is not
an essential component of clinical depression because any other 5 can
cluster together for a clinical diagnosis. The diagnostic criteria was
developed through statistical methods to identify what was depression
and the cluster system defines depression.
Biomarkers may only apply to low mood aspects of depression. Resilience
is a factor that isn't measured and may overcome the biological
component that would disable some people. There's also non-biological
depression. Many of the psychological theories of treatment are
non-biological.
So while the development of biomarkers may identify those who can
benefit from biological treatments there's still the need to identify
those who would benefit from psychological treatment and the specific
therapy that would work first time round. The issue of an individual's
reslience to emotiona pain and low mood is also necessary to take into
account when asessing what treatment to offer as well as cultural norms
and personal beliefs. The last of those is is least considered in
psychiatric research.
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