Precision Psychiatry: From Symptom-based Diagnoses to Biological Stratification

Abstract Psychiatry has historically relied on phenomenology and longitudinal clinical observation for diagnosis and treatment planning. While this approach has ensured rich clinical descriptions, it has also resulted in diagnostic ambiguity, delayed intervention, and considerable heterogeneity in treatment response. The emerging paradigm of precision psychiatry seeks to address these limitations by integrating biological markers, genetics, and objective measures with clinical judgment. Recent advances in blood-based biomarker research, particularly gene expression profiling aimed at differentiating severe mental disorders such as schizophrenia and bipolar disorder, signal a potentially transformative shift. This communication critically examines the conceptual foundations of precision psychiatry, evaluates the promise and limitations of blood-based diagnostic tools, and discusses their implications for clinical practice, research, and mental health systems. While caution is warranted against premature clinical adoption, these developments mark an important step toward biologically informed psychiatric diagnosis and individualized care.