863. Mapping the global biomarker landscape in anxiety, depression and psychosis: a global infrastructure and consensus initiative for precision psychiatry

Abstract

Abstract Background Biomarker research in psychiatry has expanded rapidly across genetic, molecular, neuroimaging, electrophysiological, behavioural and digital domains. Despite substantial scientific progress, few biomarkers have achieved routine clinical implementation. Translation is hindered by fragmented evidence, heterogeneous methodologies, inconsistent reporting standards, limited validation, and a lack of consensus regarding clinical context of use. As precision psychiatry moves towards biologically informed approaches to mental disorders, there is a growing need for a comprehensive overview of the biomarker landscape and a structured framework to evaluate readiness for clinical application. Aims & Objectives Within the ECNP Precision Psychiatry Roadmap Initiative, we launched an international biomarker mapping project focused on anxiety, depression and psychosis. The project aims to: (1) systematically map existing biomarker evidence across multiple levels of analysis; (2) create an open and searchable inventory of completed and ongoing biomarker initiatives; (3) characterise biomarkers according to their intended clinical application and stage of validation; (4) identify scientific, methodological and implementation gaps; and (5) support international consensus building towards clinically actionable biomarkers and precision psychiatry. Method The initiative combines two complementary approaches. First, an umbrella systematic review is being conducted according to PRISMA guidelines across PubMed, Web of Science, Embase, PsycINFO, Cochrane Library and PROSPERO. Biomarkers are classified according to level of analysis, context of use, diagnostic scope, and stage of validation. Second, an international stakeholder survey was developed to capture information on completed and ongoing biomarker initiatives from researchers, clinicians, industry partners, data platforms and other stakeholders. Survey data will be integrated with evidence from the literature to develop an open-access biomarker database. Findings will inform a series of international multi-stakeholder consensus meetings involving researchers, clinicians, regulators, industry representatives and people with lived experience. Results Preliminary literature searches identified 871 records in PubMed, 1,183 in Web of Science, 2,374 in Embase and 666 in PsycINFO related to biomarkers in mental disorders. Searches of the PROSPERO registry identified 364 ongoing or registered evidence syntheses in anxiety disorders, 622 in depression and 104 in psychosis. Early inspection suggests a predominance of neuroimaging and inflammatory biomarkers, alongside substantial heterogeneity in study design, outcome definitions and validation approaches. The stakeholder engagement phase is currently underway through international research networks and collaborations. Outputs from the survey and mapping exercise will be discussed at three upcoming ECNP-led multi-stakeholder consensus meetings involving researchers, clinicians, regulators, industry representatives and people with lived experience. Discussion & Conclusions The scale and diversity of current biomarker research highlight both the opportunities and challenges facing precision psychiatry. Beyond biomarker discovery, progress towards clinical implementation requires shared infrastructure, transparent evidence standards, harmonised terminology and coordinated international collaboration. By integrating systematic evidence mapping with global stakeholder engagement and consensus building, this project aims to create a field-wide resource that supports biomarker evaluation, prioritisation and translation into clinically useful applications for mental disorders.