Depression is a severe and debilitating disorder that is highly prevalent and, especially when unsuccessfully treated, can have detrimental effects on the lives of those affected, one of the most severe effects being ending one’s own life. Finding the best treatment for the individual early on in the course of the illness is therefore crucial. Despite overall effectiveness of different approved depression treatments, a substantial number of patients experiences no or only little symptom improvement. With increasing failed treatment attempts, the likelihood of achieving remission diminishes, and after multiple futile treatment courses a patient is considered difficult-to-treat. These patients often move on to receive noninvasive brain stimulation, such as rTMS, which shows good efficacy at the group level, but still results in a considerable number of non-remitters. One strategy to enhance treatment response is individualizing treatment to the patient, so called precision psychiatry. Within the context of precision psychiatry, stratified psychiatry can aid in identifying the best out of multiple approved treatments for a given disorder, for instance by means of imaging biomarkers. In this thesis, thanks to rigorous testing in multiple, diverse clinical datasets and validation of effects in independent samples, Brainmarker-I is developed and investigated as a robust transdiagnostic stratification biomarker that is ready for implementation in clinical practice.
About the author(s)
Helena Voetterl
