Validated metabolomic biomarkers in psychiatric disorders: a narrative review.

Publication date: Jul 09, 2025

Schizophrenia, major depressive disorder, bipolar disorder and posttraumatic stress disorder are severe and profoundly debilitating mental illnesses. Due to their heterogeneity and polygenic nature, the metabolic pathways and biological mechanisms underlying these conditions remain elusive. Consequently, diagnosing psychiatric disorders is a complex and multifaceted process, relying on clinical assessment and standardized diagnostic criteria. There is a growing demand to identify and integrate potential biomarkers for these disorders, especially for early diagnosis, to enhance diagnostic accuracy and complement existing diagnostic tools. Validating potential diagnostic biomarkers is essential to ensure their accuracy, reliability, generalizability, and clinical utility. In this article we provide a comprehensive review of validated metabolomics research, focusing on both the specific psychiatric conditions and the types of validation performed. Our scope is limited to peer-reviewed studies that include studies that performed validation studies in independent cohorts, cross-validation, or external validation. Due to the lack of published research, most of these validation studies have concentrated on major depressive disorder and schizophrenia, with fewer studies addressing bipolar disorder and posttraumatic stress disorder. Biomarkers are considered as validated if they demonstrated reproducibility in additional cohorts and biological relevance across independent datasets. However, several limitations must be acknowledged, including the heterogeneity in study design, small sample sizes, different analytical platforms, and inconsistent validation criteria across studies. Published results reveal that potential metabolomics biomarkers pertain to diverse categories pointing to a range of cellular, biological, and metabolic processes and emphasizing the intricate nature of psychiatric disorders. Such findings illustrate the formidable challenge of identifying and validating clinically useful metabolomic biomarkers and underscore the necessity for further research that encompasses various validation methodologies.

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Concepts Keywords
Biomarkers Biomarkers
Early Metabolomics
Heterogeneity Psychiatric disorders
Posttraumatic Validation
Schizophrenia

Semantics

Type Source Name
disease MESH psychiatric disorders
disease MESH Schizophrenia
disease MESH major depressive disorder
disease MESH bipolar disorder
disease MESH posttraumatic stress disorder
pathway KEGG Metabolic pathways
pathway REACTOME Reproduction
disease MESH etiology
disease MESH comorbidity
drug DRUGBANK Coenzyme M
drug DRUGBANK Copper
disease MESH lifestyle factors
disease MESH psychotic disorders
disease MESH hallucinations
disease MESH delusions
disease MESH abnormal movements
disease MESH apathy
disease MESH epilepsy
disease MESH tumors
disease MESH infections
disease MESH substance use
disease MESH affective symptoms
disease MESH depression
disease MESH depressive disorder
disease MESH affective disorders
disease MESH anhedonia
disease MESH anxiety
disease MESH suicide
disease MESH marital status
disease MESH physical inactivity
disease MESH treatment resistant depression
disease MESH mania
disease MESH irritable mood
disease MESH confusion
disease MESH personality disorders
disease MESH insomnia
drug DRUGBANK Gold
disease MESH misdiagnosis
drug DRUGBANK Pentaerythritol tetranitrate
drug DRUGBANK L-Valine
drug DRUGBANK Trestolone
pathway KEGG Glycerophospholipid metabolism
drug DRUGBANK L-Phenylalanine
drug DRUGBANK L-Tyrosine
drug DRUGBANK Taurine
pathway REACTOME Metabolism
drug DRUGBANK Azelaic acid
pathway REACTOME Phenylalanine metabolism
pathway KEGG Glycerolipid metabolism
pathway KEGG Histidine metabolism
pathway KEGG Ether lipid metabolism
drug DRUGBANK L-Arginine
pathway REACTOME Fatty acids
drug DRUGBANK Indole
drug DRUGBANK Butyric Acid
drug DRUGBANK Icosapent
drug DRUGBANK Amino acids
drug DRUGBANK Pidolic Acid
drug DRUGBANK Proline
drug DRUGBANK Uric Acid
drug DRUGBANK Tocopherol
drug DRUGBANK Olanzapine
disease MESH tryptophan
drug DRUGBANK L-Tryptophan
drug DRUGBANK Caprylic acid
drug DRUGBANK Urea
drug DRUGBANK Alpha-Linolenic Acid
drug DRUGBANK Sorbitol
disease MESH oxidative stress
drug DRUGBANK Methionine
drug DRUGBANK gamma-Aminobutyric acid
drug DRUGBANK Tyramine
drug DRUGBANK Quinolinic Acid
drug DRUGBANK Escitalopram
drug DRUGBANK Bupropion
drug DRUGBANK Venlafaxine
drug DRUGBANK Mirtazapine
drug DRUGBANK Citalopram
drug DRUGBANK Acetylcarnitine
drug DRUGBANK Methyl isocyanate
drug DRUGBANK Glycine betaine
drug DRUGBANK Creatinine
drug DRUGBANK Formic Acid
drug DRUGBANK L-Alanine
drug DRUGBANK L-Citrulline
drug DRUGBANK Chenodeoxycholic acid
drug DRUGBANK Glycine
drug DRUGBANK Biopterin
drug DRUGBANK Phosphoric acid
drug DRUGBANK Glutamic Acid
drug DRUGBANK Platelet Activating Factor
drug DRUGBANK Choline
drug DRUGBANK Indoleacetic acid
drug DRUGBANK Ornithine
drug DRUGBANK Hypoxanthine
drug DRUGBANK Sphingosine
drug DRUGBANK Phosphate ion
drug DRUGBANK Omega-3 fatty acids
pathway REACTOME Apoptosis
drug DRUGBANK Phosphatidyl serine
pathway REACTOME Immune System
pathway REACTOME Phospholipid metabolism
disease MESH inflammation
drug DRUGBANK Acetylcholine
disease MESH autism
disease MESH attention deficit hyperactivity disorder
drug DRUGBANK Methylergometrine
drug DRUGBANK Dopamine
drug DRUGBANK Serotonin
drug DRUGBANK Dextrose unspecified form
drug DRUGBANK Ursodeoxycholic acid
drug DRUGBANK Dehydrocholic acid
drug DRUGBANK Ketamine
disease MESH relapse
drug DRUGBANK Histidine
drug DRUGBANK Niacin
drug DRUGBANK L-Cysteine
drug DRUGBANK L-Glutamine
drug DRUGBANK L-Lysine
drug DRUGBANK Serine
drug DRUGBANK Inositol
pathway REACTOME Release
drug DRUGBANK L-methionine (R)-S-oxide
drug DRUGBANK Hydroxyproline
pathway REACTOME Glucose metabolism
drug DRUGBANK Fumaric Acid
drug DRUGBANK Maltose
drug DRUGBANK Gluconic Acid
pathway REACTOME Glycolysis
drug DRUGBANK Lipoic Acid
drug DRUGBANK ATP
drug DRUGBANK Phosphocreatine
drug DRUGBANK Succinic acid
drug DRUGBANK Acetate ion
disease MESH insulin resistance
pathway KEGG Insulin resistance
drug DRUGBANK Oxygen
disease MESH mitochondrial dysfunction
drug DRUGBANK Esomeprazole
pathway KEGG Purine metabolism
drug DRUGBANK Glutathione
drug DRUGBANK Fenamole
disease MESH privacy
pathway REACTOME Translation
disease MESH syndrome
drug DRUGBANK Guanosine
drug DRUGBANK Lenvatinib
disease MESH suicidal ideation
disease MESH neurological disorders

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