Blood tests offer new hope for people with depression, bipolar Mental Health News

A blood test using RNA markers offers new expectations for people with mood disorders, such as depression, which may be an important breakthrough in the diagnosis of mental health conditions.

A team at Indiana University School of Medicine launched a blood test in April, saying psychiatry is the first biological response to diagnose a mood disorder.

“Our research shows that it is possible to perform blood tests for depression and bipolar disorder, which have clinical utility, which separate the two, and link people to appropriate medications,” said Dr. Alexander Niculescu, a psychiatrist and geneticist. research.

“This avoids years of trial and error, hospitalizations and side effects. Because they are very common disorders, we believe we can do a lot of good with this and the tests and applications we have developed.”

Research has delved into the biological basis of mood disorders by developing a tool to differentiate what type of mood disorder a person has: depression or bipolar disorder.

To develop the test, Dr. Niculescu’s team has relied on previous 15 years of research to examine how psychiatry relates to biomarker expressions of blood genes as measurable indicators of a biological status as RNA, DNA, protein, or other molecules.

Dr. Niculescu says that all body systems — the brain, the nervous system, the immune system — have a common path of development.

“For example, when you are stressed or depressed, there are psycho-neurological mechanisms, hormones, and other things that affect your blood and your immune system,” Al Jazeera said.

Conversely, immune activation or inflammation would affect the brain.

In the first phase of the study, the team identified a list of RNA biomarkers that can monitor mood states over a period of time. After validation in an independent cohort of subjects with severe clinical depression and clinically severe mania, 26 biomarkers were completed and reduced to 12 through further testing.

With these findings, doctors could send patients to a laboratory for blood tests to indicate the causes of their symptoms, as in the case of a physical illness, says Dr. Niculescu.

Biomarkers may also contribute to treatment, as some of them were caused by Selective Serotonin Restoration Inhibitors (SSRIs), a class of antidepressants. Three other studies have identified previous effects of lithium carbonates, which are used in bipolar treatment.

“Depending on which of those biomarkers changes [a patient], we have a list of medications sorted by matching… [the patient’s] biological profile, ”Dr. Niculescu said.

The blood tests developed by Dr. Niculescu and his team are now available as a CLIA test to be requested by doctors through a company created by Niculescu and other experts in the field. CLIA is a set of U.S. government standards for laboratories that test human specimens for health assessment or to diagnose, prevent, or treat diseases.

But according to Alexander Talkovsky, head of the Translational Research Division program at the U.S. National Institute of Mental Health (NIMH), there is still research to be done. The key is whether the findings are repeated by independent researchers, he added.

This process has been done as part of the study, says Dr. Niculescu, through several steps of testing and validation in independent cohorts. According to the study, large-scale independent genetic research released after the end of the study also yielded promising results.

But what if the premise of the study is inherently wrong?

Professor Ian Hickie, co-director of health and policy at the University of Sydney’s Brain and Mind Center and former Australian commissioner of mental health, says it is difficult to find an algorithm that applies to all patients with mood disorders because of such disorders. they are based on individual and clinical presentation at different stages of life.

His team is linking physiology and biology to people’s symptoms, not their disease category.

“What systems are really upset? How are they represented? What are some of the markers you can see? ” he said. “And [then] What is the combination of biological treatments, behavior, and other treatments that corrects the condition… and then keeps you well? ”

Basically, all of these findings can be used in conjunction with clinical evaluation to achieve a more accurate and conclusive diagnosis and treatment, he says.

Objective testing can change early diagnosis

Objective testing can be of great importance for patients who are currently in a very slow diagnostic process.

For the bipolar in particular, it may take years for the full range of symptoms to evolve.

Sydney psychiatrist Dr Sonia Kumar says that often bipolar disorder will first appear as depression, and symptoms of mania will appear later.

Other times, the symptoms may be there, but so low in the spectrum that the diagnosis is not clear until it has evolved.

If there were a biological test that could elucidate these variables along with clinical evaluation, Kumar says, clinicians could begin specific treatment earlier, which can alleviate a great deal of suffering before that happens.

Research partner Katrin Inci believes that early diagnosis of her bipolar disorder could have saved years of unresolved years of suffering, as well as the severity that increased after her episodes were diagnosed.

He was diagnosed with depression at the age of 13 and prescribed Zoloft, a type of antidepressant known to cause mania in bipolar patients.

“[It] It put me in a manic episode that lasted until I was 19, when I was first hospitalized, ”he said.

After being hospitalized, when Inci finally received a correct diagnosis, she spent 10 years testing new drugs, navigating bipolar episodes, and beginning to seek well-being.

Dr. Niculescu says objective tests for disorders like depression can help reduce stigma associated with mental health conditions [Supplied]

He believes that if he had been properly diagnosed at the age of 13, his illness would not have become so serious.

Research shows that bipolar and unipolar depression are degenerative diseases.

“If I had been treated first … I would have had fewer episodes,” Inci told Al Jazeera. “I see it that way [fewer] hospitalizations, which would save me a lot of money and time, and a lot of anxiety. ”

Objective testing for mood disorders like this blood test may also be key to reducing the stigma associated with mental health conditions, says Dr. Niculescu.

“People will realize that it’s just a biological disorder … it’s not a moral vulnerability, you’re not lazy and so on,” he says.

Violet, a Russian model who only wants to share her name, has been living and working in depression for years.

He says he has internalized the stigma and often feels “lying”.

“Sometimes I feel … I’m looking for attention or something,” he said. “These are things that accuse you a lot, even from people close to you … and then you start wondering what happens if I’m just a selfish person who really wants a lot of attention?”

The data go a long way in dispelling that doubt, explained Kasia, an employee of the Sydney NGO, who asked to use only her first and last name.

The diagnosis of depression in adulthood compares with that of those diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) in childhood.

Since diagnostic tests for ADHD were created, he was able to see objective results for his psychiatric evaluation.

“They actually showed me all my brain scans and showed me how different my brain was. It was a great day for me, it changed everything, ”he said.

Dr. Pawan Sharma, a Kathmandu-based psychiatrist, says a trial could break even more barriers to the care of his patients, especially in more isolated rural communities with low cultural awareness of mental illness.

Many of these patients are initially unaware that sadness can be a disease, says an assistant professor in the psychiatry department at Patan Academy of Health Sciences.

“They come [to physicians] physical symptoms – headaches, insomnia, loss of energy, heartbeat – and [are then referred] to psychiatrists, ”Dr. Sharma said, noting that an objective test would give patients something tangible to help them explain how they feel.

As it stands now, NIMH’s Talkovsky says Dr. Niculescu’s study has a long way to go to achieve this and to conduct psychiatric research.

“What they’re doing is a pretty important step in our ability to create objective brands [for] mental illness, ”he said.

Although still in its infancy, further research may suggest that blood test analysis can be a significant part of the psychiatric diagnostic tool, clarifying the diagnosis and changing millions of lives for the better.