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<p>Serotonin (5-hydroxytryptamine, 5-HT) is a transdiagnostic, socially calibrated biomarker for precision psychiatry. Convergent neurobiological, genomic, and behavioural data indicate that 5-HT biosynthetic capacity shapes social-cognitive processing. Receptor-level plasticity also contributes to this process. Gut–brain–immune axis signalling plays an additional role. Together, these factors sculpt affective regulation. They also influence life-long mental health trajectories. Within the predictive, preventive, and personalised medicine (predictive preventive personalised medicine (3PM)) paradigm, multiomics risk stratification, early-life dietary or probiotic modification, and individually tailored pharmacological or psychotherapeutic regimens are actionable. Progress in serotonergic (5-HTergic) biomarkers within the 3PM framework is expected to increase medical service accessibility. This enhancement occurs through multiple mechanisms. This paves the way for precise risk stratification to guide timely intervention and personalised psychiatric therapeutics across clinically distinct subpopulations. Most personality disorders and related syndromes have a well-known serotonergic signature. These range from impulsive aggression to abnormal dominance behaviors and the failure of empathy. These features underscore the diagnostic, prognostic, and therapeutic potential of serotonergic biomarkers. However, the realisation of this promise in the clinic is limited by the measurement limitations of the blood–brain barrier (blood–brain barrier (BBB)). It must also address the ethical and privacy implications of genomic screening. The 3PM roadmap is integrated and proposed in the current review. It aims at integrating serotonergic biomarkers into everyday predictive diagnostics. The roadmap further discusses preventive planning as well as tailored interventions in precision psychiatry.</p> Graphical abstract <p></p>

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Serotonin as a psychosocial biomarker in 3PM psychiatry: from the social brain to personalised intervention

  • 期刊论文

  • 发表日期：

    2026年4月11日

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  • Shengjian Ni,
  • Lixuan Guan,
  • Yuxin Jin,
  • Linjing Liu,
  • Siming Zhu,
  • Wenyang Zhao,
  • Vijayaraj Kumar Palanirajan

摘要

Serotonin (5-hydroxytryptamine, 5-HT) is a transdiagnostic, socially calibrated biomarker for precision psychiatry. Convergent neurobiological, genomic, and behavioural data indicate that 5-HT biosynthetic capacity shapes social-cognitive processing. Receptor-level plasticity also contributes to this process. Gut–brain–immune axis signalling plays an additional role. Together, these factors sculpt affective regulation. They also influence life-long mental health trajectories. Within the predictive, preventive, and personalised medicine (predictive preventive personalised medicine (3PM)) paradigm, multiomics risk stratification, early-life dietary or probiotic modification, and individually tailored pharmacological or psychotherapeutic regimens are actionable. Progress in serotonergic (5-HTergic) biomarkers within the 3PM framework is expected to increase medical service accessibility. This enhancement occurs through multiple mechanisms. This paves the way for precise risk stratification to guide timely intervention and personalised psychiatric therapeutics across clinically distinct subpopulations. Most personality disorders and related syndromes have a well-known serotonergic signature. These range from impulsive aggression to abnormal dominance behaviors and the failure of empathy. These features underscore the diagnostic, prognostic, and therapeutic potential of serotonergic biomarkers. However, the realisation of this promise in the clinic is limited by the measurement limitations of the blood–brain barrier (blood–brain barrier (BBB)). It must also address the ethical and privacy implications of genomic screening. The 3PM roadmap is integrated and proposed in the current review. It aims at integrating serotonergic biomarkers into everyday predictive diagnostics. The roadmap further discusses preventive planning as well as tailored interventions in precision psychiatry.

Graphical abstract