Looking Beyond Diagnosis: Transdiagnostic Biomarkers in Psychiatry

Diagnostic categories in psychiatry remain clinically meaningful, but they capture only part of the underlying biology driving a patient's symptoms, according to Scott Fears, MD, the chief medical officer at Amy Health and professor of psychiatry at the University of California, Los Angeles (UCLA).

In an interview with Psychiatric Times, Fears said genome-wide association studies (GWAS) conducted over the past decade support the validity of diagnoses such as depression, schizophrenia, and bipolar disorder. Comparing individuals who meet diagnostic criteria for these conditions against those who do not has identified hundreds of associated risk variants, evidence Fears said confirms these categories track something biologically real.¹

At the same time, Fears described substantial heterogeneity within single diagnoses. Schizophrenia, he said, likely represents "many paths to thought disorder" that converge on a similar clinical presentation rather than a single underlying process. Depression shows a comparable pattern: hypersomnia and hyperphagia can both signal depression, as can insomnia and anorexia—symptom clusters that may point to different underlying drivers, including neurocircuitry dysfunction, cancer, or dysregulated blood glucose in diabetes.

Amae Health's vocal analysis platform is designed to identify biomarkers of depression and anxiety from speech. Fears said the goal is for those signals to inform care beyond the diagnoses they were originally studied in, including for patients with schizophrenia or obsessive-compulsive disorder (OCD).

"We want biomarkers, and our vocal analysis identifies biomarkers of depression and anxiety. But I want those biomarkers to be used for the treatment of people with schizophrenia, with people with OCD," Fears said. "I care if it's pointing in the direction of something useful that's either going to tell me how to change treatment, how to change course, or whether we initiate treatment."

Fears framed this as a symptom—and subsymptom—level complement to existing diagnostic frameworks rather than a replacement for them, aimed at helping clinicians disentangle overlapping disorders and flag when something clinically important warrants attention, regardless of diagnostic label.²

Dr Fears is the chief medical officer at Amae Health and a professor of psychiatry at UCLA.

References

1. Howard DM, Adams MJ, Clarke TK, et al. Genome-wide meta-analysis of depression identifies 102 independent variants and highlights the importance of the prefrontal brain regions. Nat Neurosci. 2019;22(3):343-352.

2. Psychiatric Times. Brain Function Biomarker Testing In Psychiatry With Universal Brain EEG. https://www.psychiatrictimes.com/view/brain-function-biomarker-testing-in-psychiatry-with-universal-brain-eeg. Published August 21, 2026. Accessed August 25, 2026.