Good news! Amazing stuff! This is probably still early stage research!
"... The 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. ...
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. ..."
From the key points and abstract:
"Key Points
Question Can bipolar disorder (BD) be distinguished from major depressive disorder (MDD) during episodes of low mood by profiling biomarkers in patient dried blood spots (DBSs)?
Findings In this diagnostic study including 241 patients, patients with depressive symptoms with misdiagnosed BD showed a distinct profile of DBS metabolites compared with patients with depressive symptoms with MDD, which correlated with lifetime manic symptoms. Incorporating biomarker measurements into diagnostic models significantly improved predictive performance in scenarios when symptom data were limited and at uncertain diagnostic thresholds.
Meaning Metabolomic profiling of patient DBS samples has the potential to improve the differential diagnosis of mood disorders in clinically relevant scenarios.
Abstract
Importance Bipolar disorder (BD) is frequently misdiagnosed as major depressive disorder (MDD) because of overlapping symptoms and the lack of objective diagnostic tools.
Objective To identify a reproducible metabolomic biomarker signature in patient dried blood spots (DBSs) that differentiates BD from MDD during depressive episodes and assess its added value when combined with self-reported patient information.
Design, Setting, and Participants This diagnostic analysis used samples and data from the Delta study, conducted in the UK between April 27, 2018, and February 6, 2020. The primary objective was to identify BD in patients with a recent (within the past 5 years) diagnosis of MDD and current depressive symptoms (Patient Health Questionnaire–9 score of 5 or more). Participants were recruited online through voluntary response sampling. The analysis was carried out between February 2022 and July 2023.
Main Outcomes and Measures Patient data were collected using a purpose-built online questionnaire (n = 635 questions). DBS metabolites (n = 630) were analyzed using a targeted mass spectrometry–based platform. Mood disorder diagnoses were established using the Composite International Diagnostic Interview.
Results Of 241 patients in the discovery cohort, 170 (70.5%) were female; 67 (27.8%) were subsequently diagnosed with BD and 174 (72.2%) were confirmed as having MDD; and the mean (SD) age was 28.1 (7.1) years. Of 30 participants in the validation cohort, 16 (53%) were female; 9 (30%) were diagnosed with BD and 21 (70%) with MDD; and the mean (SD) age was 25.4 (6.3) years. DBS metabolite levels were assessed in 241 patients with depressive symptoms with a recent diagnosis of MDD, of whom 67 were subsequently diagnosed with BD by the Composite International Diagnostic Interview and 174 were confirmed as having MDD. The identified 17-biomarker panel provided a mean (SD) cross-validated area under the receiver operating characteristic curve (AUROC) of 0.71 (SD, 0.12; P < .001), with ceramide d18:0/24:1 emerging as the strongest biomarker. Combining biomarker data with patient-reported information significantly enhanced diagnostic performance of models based on extensive demographic data, PHQ-9 scores, and the outcomes from the Mood Disorder Questionnaire. The 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 MDD (n = 21) or BD (n = 9) during the study’s 1-year follow-up period, with a mean (SD) AUROC of 0.73 (0.06; P < .001).
Conclusions and Relevance This study provides a proof of concept for developing an accessible biomarker test to facilitate the differential diagnosis of BD and MDD and highlights the potential involvement of ceramides in the pathophysiological mechanisms of mood disorders."
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