A systematic literature review and meta-analysis of circulating nucleic acids as biomarkers in psychiatry

Common mental disorders (CMDs) such as depression, anxiety and post-traumatic stress disorders account for 40% of the global burden of disease. In most psychiatric disorders, both diagnosis and monitoring can be challenging, frequently requiring long-term investigation and follow-up. The discovery of better methods to facilitate accurate and fast diagnosis and monitoring of psychiatric disorders is therefore crucial. Circulating nucleic acids (CNAs) are among these new tools. CNAs (DNA or RNA) can be found circulating in body biofluids, and can be isolated from biological samples such as plasma. They can serve as biomarkers for diagnosis and prognoses. They appear to be promising for disorders (such as psychiatric disorders) that involve organs or structures that are difficult to assess. This review presents an accurate assessment of the current literature about the use of plasma and serum cell-free DNA (cfDNA) as biomarkers for several aspects of psychiatric disorders: diagnosis, prognosis, treatment response, and monitor disease progression. For each psychiatric disorder, we examine the effect sizes to give insights on the efficacy of CNAs as biomarkers. The global effect size for plasma nuclear and mitochondrial cfDNA studies was generally moderate for psychiatric disorders. In addition, we discuss future applications of CNAs and particularly cfDNA as non-invasive biomarkers for these diseases.

Automated summary

Recent research has found that circulating nucleic acids (CNAs) can be used as a new diagnostic and monitoring tool for mental disorders, particularly for diseases involving difficult-to-assess organs or structures. This review examines the application of plasma and serum cell-free DNA (cfDNA) as biomarkers for psychiatric disorders, including diagnosis, prognosis, treatment response, and disease progression. The overall effect size of plasma nuclear and mitochondrial cfDNA studies was generally moderate for psychiatric disorders. The future applications of CNAs, particularly cfDNA, as non-invasive biomarkers for these diseases are also discussed.