The clinical use of epigenetics in psychiatry: a narrative review of epigenetic mechanisms, key candidate genes, and precision psychiatry

The etiology of psychiatric disorders is complex, involving both genetic and environmental factors with emerging evidence suggesting that epigenetic modifications, including DNA methylation, histone modifications, and non-coding RNA regulation, significantly contribute to mental health. The epigenome influences the development of psychiatric disorders and human behavior and may be considered in clinical observations. Epigenetic changes have been well-established in BDNF , COMT , FKBP5 , NR3C1 , SLC6A4 , and DRD2 , genes associated with psychiatric disorders, including schizophrenia, major depressive disorder (MDD), bipolar disorder (BP), post-traumatic stress disorder (PTSD), and autism spectrum disorder (ASD). Therefore, these epigenetic marks have the potential to be suitable biomarkers for diagnostics, as predictors of prognosis, and for the development of personalized treatments. By exploring the role of clinically releva