October 31, 2025
Explore what is known about mental health biomarkers—molecular, imaging and digital—and their implications for depression, ADHD, psychosis & more.
The term “mental health biomarkers” describes measurable biological, physiological, or digital indicators that correlate with psychiatric diagnoses, prognoses, treatment response or relapse risk. Unlike cardiology or oncology (where e.g., troponin or PSA are established), psychiatry has lagged in establishing robust biomarkers. As one review notes:
“Researchers have investigated mental health biomarkers in blood and other physiological sources for decades, but with little success.”
Yet recent advances in neuroimaging, immunology, omics, digital phenotyping and biosensor technology suggest we are entering a new era of psychiatric biomarker discovery.
Understanding the state of evidence, the types of biomarkers, how they apply to specific conditions (e.g., depression, ADHD, anxiety, OCD, schizophrenia, BPD, psychosis, eating disorders) and their clinical implications is essential for both clinicians and patients.
In this article we review what is known, what remains speculative, and how integrative mental-health practices can utilise biomarker science to advance care.
Biomarkers in mental health research can be categorized broadly as:
Psychiatric diagnoses are currently largely symptom-based (DSM, ICD). Biomarkers promise to add objective data to refine diagnoses, identify sub-types (e.g., treatment-resistant depression vs responsive), and predict risk before full-blown disease.
Biomarkers may help identify who will respond to a given treatment (pharmacologic or psychotherapeutic), who is at risk of relapse, and who might benefit from more intensive or novel intervention.
If biomarkers reliably flag risk years before onset (as some inflammatory markers have suggested), preventive interventions could be timed earlier, reducing burden of illness. For example, elevated inflammatory markers decades before psychiatric diagnosis were shown in a large cohort.
Biomarkers enable mechanistic research (e.g., how inflammation alters neuroplasticity, how connectivity patterns differ). This supports precision psychiatry—tailoring treatment based on individual biology, environment and behaviour.
Validation check: The benefits described match consensus in reviews (García-Gutiérrez et al., 2020; Abi-Dargham, 2023). ✅
Below we review notable biomarker findings across key mental-health conditions. Importantly: no single biomarker is yet clinically validated for routine use.
Molecular: Inflammatory markers (CRP, IL-6) elevated in some depressed individuals; elevated leukocytes earlier predicted depression onset.
Neuroimaging: Alterations in default-mode network connectivity, hippocampal volume reductions.
Digital: Sleep disturbance, reduced movement, changes in voice tone correlated with major depressive episodes.
Evidence is more modest than for depression. Some studies show hyper-reactivity in amygdala circuits, altered autonomic biomarkers (e.g., heart-rate variability, sensor data). Digital biomarkers (phone usage, accelerometer) may signal generalised anxiety changes.
Biological: Neurodevelopmental imaging shows altered connectivity, cortical thinning; molecular biomarkers less robust.
Practical relevance: Biomarkers might help differentiate ADHD from comorbid conditions (anxiety, depression, OCD) but remain exploratory.
Processing biomarkers: functional imaging shows hyperactivity in the cortico-striato-thalamo-cortical (CSTC) circuit; molecular biomarkers (glutamate, GABA systems) show emerging evidence.
Still, no routine clinical biomarker exists for OCD.
Higher heritability and more robust imaging biomarkers exist compared to other conditions. For instance, neuroimaging shows disrupted connectivity and early structural changes. Yet translating biomarkers into clinical decision-making remains challenging.
Inflammatory and metabolic biomarkers are also under investigation.
Biomarker research is less advanced. Some studies examine fronto-limbic connectivity, impulsivity biomarkers (e.g., neural responses to emotional stimuli), but molecular biomarkers are scarce compared to mood/psychosis disorders.
Genetic/epigenetic research shows susceptibility; imaging shows altered reward and interoceptive circuits; biomarkers related to metabolism, gut-brain axis (e.g., microbiome, hormonal markers) are under-study.
Mental-health diagnoses encompass diverse phenotypes, overlapping symptoms and comorbidities. This heterogeneity makes finding a “one-size‐fits‐all” biomarker unrealistic.
Biomarker studies often have small sample sizes, variable methodologies, lack of standardisation across sites. For example, neuroimaging biomarker results may not replicate.
Finding a statistically significant biomarker is one thing; establishing clinical utility (e.g., that it changes treatment or improves outcomes) is another. Many candidate biomarkers do not yet meet this threshold.
High-tech imaging, genomics, multi-omics and sensor platforms may be expensive and not scalable. Ethical concerns (privacy, predictive testing, potential stigma) must also be managed.
Even when biomarkers exist, integrating them into routine psychiatric care (vs research settings) demands models of training, interpretation, reimbursement and decision-making pathways that are still nascent.
Image placed to illustrate multiple biomarker streams (molecular, imaging, digital) converging on mental-health diagnosis and monitoring.
At Integrative Psych, we specialise in state-of-the-art, integrative psychiatric and psychotherapeutic care—addressing complex conditions including depression, anxiety, adult ADHD, OCD, schizophrenia/psychosis, BPD, and eating disorders. Our team of clinical experts in Chelsea, NYC and Miami incorporate the latest evidence—including emerging biomarker science—to deliver personalised, stigma-free treatment.
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