This is the newest and reliable method of distinguishing bipolar disorder from major depressive disorder that could save thousands of lives.
Researchers at Chongqing Medical University, China, claim to have found an easy way of diagnosing bipolar disorder in a study based on the biomarkers in urine.
The symptoms of a bipolar can be very difficult to distinguish from those of major depressive disorder (MDD). Since MDD is the more common condition, clinicians often jump to an MDD diagnosis without even investigating the possibility of bipolar. Studies have found that as many as 39% of patients diagnosed with MDD have unrecognized bipolar.
A large percentage of Bipolar Disorder subjects are incorrectly treated with antidepressants in clinical practice and the consequences can be lethal. Selective seratonin reuptake inhibitors (SSRIs) such as Prozac and Celexa probably don’t help people with bipolar. SSRIs are alleged to increase suicide risk among bipolar patients, a major concern since bipolar sufferers have suicide rates around 20 times the population as a whole.
While efforts have been made to alert doctors to the dangers of this sort of misdiagnosis, as long as we continue to rely only on many subdued signs, the problem will remain. The Chongquing team think they have found a way out of this problem as having identified biomarkers whose concentrations are different for people with bipolar or MDD.
According to the authors of the new paper in The Journal Proteome, some of these biomarkers have been investigated before, but individually did not provide a sufficiently reliable method for diagnosis. However, senior author,Dr. Peng Xie, proposed that multiple markers in combination might succeed where each had failed.
For the study, experienced psychiatrists recruited 71 people with bipolar disorder, 126 whose diagnosis of MDD was considered reliable, and 126 “healthy controls.” Each group was divided into a training set and a test set. For the training set, the researchers knew the subject’s condition ahead of time and used this to identify relevant markers, while in the other set it was a blinded test to confirm the predictive capacity of these markers. The researchers examined the urine of those in the training set to identify 20 metabolites associated with either MDD or bipolar.
An initial trial on the test set identified 76% of those with MDD and 79% of those with bipolar, falling short of what would be required clinically. However, when the results were reanalyzed, six metabolites stood out.
After normalizing these six metabolites to creatinine concentration in urine, they found out that they could achieve 90% reliability in distinguishing between the two conditions.
Furthermore, the authors note that the study’s subjects had a common ethnicity and had been treated at the same hospital, necessitating further research to see whether the results can be generalized. However, the research adds to work published last year suggesting biomarkers could play a major role in depression diagnosis.
via Medical Daily