̽��ֱ�� of Cambridge - biomarker

Simple blood test can help diagnose bipolar disorder

sc604 — Wed, 25 Oct 2023 15:00:00 +0000

̽��ֱ��researchers, from the ̽��ֱ�� of Cambridge, used a combination of an online psychiatric assessment and a blood test to diagnose patients with bipolar disorder, many of whom had been misdiagnosed with major depressive disorder.

̽��ֱ��researchers say the blood test on its own could diagnose up to 30% of patients with bipolar disorder, but that it is even more effective when combined with a digital mental health assessment.

Incorporating biomarker testing could help physicians differentiate between major depressive disorder and bipolar disorder, which have overlapping symptoms but require different pharmacological treatments.

Although the blood test is still a proof of concept, the researchers say it could be an effective complement to existing psychiatric diagnosis and could help researchers understand the biological origins of mental health conditions. ̽��ֱ��results are reported in the journal JAMA Psychiatry.

Bipolar disorder affects approximately one percent of the population – as many as 80 million people worldwide – but for nearly 40% of patients, it is misdiagnosed as major depressive disorder.

“People with bipolar disorder will experience periods of low mood and periods of very high mood or mania,” said first author Dr Jakub Tomasik, from Cambridge’s Department of Chemical Engineering and Biotechnology. “But patients will often only see a doctor when they’re experiencing low mood, which is why bipolar disorder frequently gets misdiagnosed as major depressive disorder.”

“When someone with bipolar disorder is experiencing a period of low mood, to a physician, it can look very similar to someone with major depressive disorder,” said Professor Sabine Bahn, who led the research. “However, the two conditions need to be treated differently: if someone with bipolar disorder is prescribed antidepressants without the addition of a mood stabiliser, it can trigger a manic episode.”

̽��ֱ��most effective way to get an accurate diagnosis of bipolar disorder is a full psychiatric assessment. However, patients often face long waits to get these assessments, and they take time to carry out.

“Psychiatric assessments are highly effective, but the ability to diagnose bipolar disorder with a simple blood test could ensure that patients get the right treatment the first time and alleviate some of the pressures on medical professionals,” said Tomasik.

̽��ֱ��researchers used samples and data from the Delta study, conducted in the UK between 2018 and 2020, to identify bipolar disorder in patients who had received a diagnosis of major depressive disorder within the previous five years and had current depressive symptoms. Participants were recruited online through voluntary response sampling.

More than 3000 participants were recruited, and they each completed an online mental health assessment of more than 600 questions. ̽��ֱ��assessment covered a range of topics that may be relevant to mental health disorders, including past or current depressive episodes, generalised anxiety, symptoms of mania, family history or substance abuse.

Of the participants who completed the online assessment, around 1000 were selected to send in a dried blood sample from a simple finger prick, which the researchers analysed for more than 600 different metabolites using mass spectrometry. After completing the Composite International Diagnostic Interview, a fully structured and validated diagnostic tool to establish mood disorder diagnoses, 241 participants were included in the study.

Analysis of the data showed a significant biomarker signal for bipolar disorder, even after accounting for confounding factors such as medication. ̽��ֱ��identified biomarkers were correlated primarily with lifetime manic symptoms and were validated in a separate group of patients who received a new clinical diagnosis of major depressive disorder or bipolar disorder during the study’s one-year follow-up period.

̽��ֱ��researchers found that the combination of patient-reported information and the biomarker test significantly improved diagnostic outcomes for people with bipolar disorder, especially in those where the diagnosis was not obvious.

“ ̽��ֱ��online assessment was more effective overall, but the biomarker test performs well and is much faster,” said Bahn. “A combination of both approaches would be ideal, as they’re complementary.”

“We found that some patients preferred the biomarker test, because it was an objective result that they could see,” said Tomasik. “Mental illness has a biological basis, and it’s important for patients to know it’s not in their mind. It’s an illness that affects the body like any other.”

“In addition to the diagnostic capabilities of biomarkers, they could also be used to identify potential drug targets for mood disorders, which could lead to better treatments,” said Bahn. “It’s an exciting time to be in this area of research.”

A patent has been filed on the research by Cambridge Enterprise, the ̽��ֱ��’s commercialisation arm. ̽��ֱ��research was supported by the Stanley Medical Research Institute and Psyomics, a ̽��ֱ�� spin-out company co-founded by Sabine Bahn.

Sabine Bahn is Professor of Neurotechnology at the Department of Chemical Engineering and Biotechnology and is a Fellow of Lucy Cavendish College, Cambridge.

Reference:
Jakub Tomasik et al. ‘Metabolomic Biomarker Signatures for Bipolar and Unipolar Depression.’ JAMA Psychiatry (2023). DOI: 10.1001/jamapsychiatry.2023.4096

Researchers have developed a new way of improving diagnosis of bipolar disorder that uses a simple blood test to identify biomarkers associated with the condition.

̽��ֱ��ability to diagnose bipolar disorder with a simple blood test could ensure that patients get the right treatment the first time

Jakub Tomasik

Cambridge Centre for Neuropsychiatric Research

Providing a drop of blood for a test

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Scientists identify depression and anxiety biomarker in youths

gm349 — Wed, 28 Nov 2012 22:00:13 +0000

Scientists have discovered a cognitive biomarker – a biological indicator of a disease – for young adolescents who are at high risk of developing depression and anxiety. Their findings were published today, 28 November, in the journal PLOS ONE.

̽��ֱ��test for the unique cognitive biomarker, which can be done on a computer, could be used as an inexpensive tool to screen adolescents for common emotional mental illnesses. As the cognitive biomarker may appear prior to the symptoms of depression and anxiety, early intervention (which has proven to be one of the most effective ways of combating mental illness) could then be initiated.

For the study, 15-18 year old participants underwent genetic testing and environmental assessment, an exercise which would currently be too expensive and take too long to use as a widespread method of screening. ̽��ֱ��adolescents were then given a computer test to gauge how they process emotional information. ̽��ֱ��test had the participants evaluate whether words were positive, negative or neutral (examples included ‘joyful’ for positive, ‘failure’ for negative, and ‘range’ for neutral).

Those adolescents with a variation of one gene (the short form of the serotonin transporter) as well as exposure to intermittent family arguments for longer than six months and violence between parents before the age of six were shown to have marked difficulty in evaluating the emotion within the words, indicating an inability to process emotional information. Previous research associated a maladjusted perception and response to emotions, as seen here, with a significantly increased risk of depression and anxiety.

Professor Ian Goodyer, Principal Investigator on the study from the ̽��ֱ�� of Cambridge, said: “Whether we succumb to anxiety and depression depends in part on our tendencies to think well or poorly of ourselves at troubled times. How it comes about that some people see the ‘glass half full’ and think positively whereas other see the ‘glass half empty’ and think negatively about themselves at times of stress is not known.

“ ̽��ֱ��evidence is that both our genes and our early childhood experiences contribute to such personal thinking styles. Before there are any clinical symptoms of depression or anxiety, this test reveals a deficient ability to efficiently and effectively perceive emotion processes in some teenagers – a biomarker for low resilience which may lead to mental illnesses.”

̽��ֱ��scientists hope that their research could lead to developing inexpensive cognitive tests to screen for these illnesses, particularly in people identified as being at high social and genetic risk.

Dr Matthew Owens from the ̽��ֱ�� of Cambridge added: “Having difficulty in processing emotions is likely to contribute to misunderstanding other people’s intentions and can make individuals emotionally vulnerable. This research opens up the possibility of identifying individuals at greatest risk and helping them with techniques to process emotions more easily or training them to respond more adaptively to negative feedback.”

Professor Goodyer further stated: “These types of cognitive biomarker can also be used to aid therapeutics by helping to determine which treatments are likely to work best for types of depressions and anxiety disorders. This is important, as although we have good treatments we do not yet know what works best for whom.”

Professor Barbara Sahakian, a co-author on the paper from the Department of Psychiatry at the ̽��ֱ�� of Cambridge said: “ ̽��ֱ��way we perceive and respond to emotions affects our resilience and whether we succumb to depression and other maladaptive ways of thinking. Using the biomarker identified in this study, it is possible to develop a screening programme to identify those at greatest risk.”

Mental health problems are common in young people with approximately 10% of children (aged 5-16 years old) in Great Britain being assessed as having a mental disorder of some kind including conduct disorder, emotional disorder or hyperactivity. In addition, adolescence is a critical period for the development of depressions.

̽��ֱ��research was funded by the Wellcome Trust and the National Institute of Health Research Cambridgeshire and Peterborough Collaborations for Leadership in Applied Health Research and Care (NIHR CLAHRC)

Test could be used as an inexpensive screening tool to facilitate early intervention.

This test reveals a deficient ability to efficiently and effectively perceive emotion processes in some teenagers.

Ian Goodyer

D Sharon Pruitt from flickr

Where Angels Cry

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