Abstract:In psychiatry, the reliability of diagnosis (a symptom-based approach) isinstrumental in the management of medications and treatments. The NationalInstitute of Mental Health (NIMH) is now searching for neurobiological measuresthat account for observed and reported symptoms. The results of our study of386 refractory clinical cases suggest there are four neurobiological measuresthat account for medication failure: encephalopathy, focal slowing, betaspindles and transient discharges. One or more of these neurobiologicalmeasures (neurobiomarkers) explained why medication failed in each of theserefractory cases. Our investigation found positive correlations between numbersof medications being prescribed and numbers of neurobiomarkers being identifiedin children and adolescents. In adults we also we found a positive correlationbetween numbers of medications being prescribed and number of diagnoses. Thisstudy represents a model that could improve the efficacy of the psychotropicintervention and treatment selection in refractory psychiatric cases.