Precision Medicine in Schizophrenia: Systematic Review of Biomarkers in African Populations

A systematic review of precision medicine research in schizophrenia among African populations reveals a growing body of evidence regarding the complex biological underpinnings of this severe psychiatric disorder, highlighting critical gaps in current understanding and clinical application within African settings. Schizophrenia, recognized globally as a psychiatric disorder characterized by substantial clinical heterogeneity and variable treatment response, necessitates the development of objective biomarkers to support accurate diagnosis, predict prognosis, and facilitate personalized treatment strategies. While global biomarker research has expanded significantly, African populations, given their extensive genetic diversity and unique environmental exposures, have historically been underrepresented in this field. This comprehensive systematic review, conducted in accordance with PRISMA guidelines, synthesized data from twenty-eight studies—comprising nineteen case-control studies and nine observational studies—conducted across seven diverse African countries, aiming to synthesize the available evidence on schizophrenia biomarkers and precision medicine approaches specific to these populations.

The investigation into blood-based biomarkers was particularly extensive, encompassing seventeen of the included studies. Researchers focused on several key categories of biomarkers, including inflammatory markers, oxidative stress indicators, lipid profiles, complement factors, circulating microRNAs, and transcriptomic signatures. The synthesized findings consistently pointed toward several pathological trends among individuals diagnosed with schizophrenia. Specifically, there was a consistent observation of elevated inflammatory and immune-related markers, alongside evidence of increased oxidative stress and dysregulated lipid metabolism. Furthermore, analyses of transcriptomic and microRNA expression profiles demonstrated significant alterations, suggesting that molecular pathways related to immune function and cellular stress are profoundly affected in this population. These consistent findings underscore the biological complexity of the disorder and point toward systemic dysregulation within the host.

Beyond blood-based indicators, the review also analyzed thirteen studies focusing on genetic biomarkers. These genetic investigations were primarily aimed at understanding diagnostic utility, disease susceptibility, pharmacogenomics, and predicting treatment response to antipsychotic medications. The research identified several genetic variants that were significantly associated with schizophrenia susceptibility, symptom severity, metabolic abnormalities, and differential responses to antipsychotic treatments. Moreover, emerging research utilizing advanced technologies such as transcriptomics, exome sequencing, and microbiome studies provided deeper insights. These studies further illuminated molecular pathways implicated in crucial biological processes such as immune regulation, neurodevelopmental processes, neurotransmission mechanisms, and ultimate treatment outcomes, thereby expanding the scope of precision medicine beyond simple diagnostic markers.

Despite the promising associations identified for both blood-based and genetic biomarkers in relation to diagnosis, prognosis, and pharmacogenomics, the overall evidence base remains fragmented and highly heterogeneous. The majority of the current findings are derived from small, relatively homogenous studies that are geographically concentrated within a limited number of African countries. This limitation is a critical finding of the review, suggesting that while the evidence supports the expanding role of precision psychiatry in the management of schizophrenia, the current data is insufficient for widespread clinical validation. The heterogeneity in study design, population characteristics, and biomarker selection further complicates the direct translation of these findings into robust clinical protocols within African healthcare systems.

The systematic review ultimately concludes that while several molecular signatures, ranging from circulating microRNAs to specific genetic variants, show potential relevance to the pathogenesis and management of schizophrenia, significant hurdles remain. The necessity for larger, multicentre studies that incorporate greater ethnic diversity is strongly emphasized. Future research must focus on validating these promising biomarker candidates across broader, more representative African cohorts to ensure that the findings are robust and applicable to the diverse genetic and environmental landscape of the continent. This ongoing effort is crucial to facilitate the effective translation of precision psychiatry into practical clinical practice within African settings, moving the field beyond initial associations toward definitive, actionable diagnostic and therapeutic tools.

Subject of Research: Systematic review of precision medicine research and biomarkers for schizophrenia in African populations.

Article Title: A systematic review of precision medicine research in schizophrenia among African populations

Article References: Obeng, A. P., Kawuo, S., Choon-Quinones, M., Quinones, H., Mohammed, I., Obeng, G. D., Asiedu-Ayeh, B., Ankamah, S., Imre, A., & Csanádi, M. (2026). A systematic review of precision medicine research in schizophrenia among African populations. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08824-1

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DOI: 10.1186/s12888-026-08824-1

Keywords: Schizophrenia, Precision Medicine, Biomarkers, African Populations, Systematic Review, Genetics, Psychiatry, Biomolecular Signatures, systematic, review, precision, medicine