Health

Game Changer: A Medical Test to Gauge Mental Health

Feature Image courtesy of Tim Mossholder
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Mental health diagnosis with accurate information on depression can now be achieved with a newly developed blood test!

With mental health awareness on the rise around the world, more people are learning that major mental health struggles like depression can affect people of all social classes regardless of background, age, or upbringing. With stigmatization against mental health treatments becoming less rampant —especially in a COVID-stricken world where metal health issues have skyrocketed — the way we look at mental health has changed drastically, signifying a better approach in treating depression. Although still far from perfect, the shift in attitudes towards mental health advocacy has indeed improved, even here in Southeast Asia.

Image Credit: Anthony Tran

For the most part, stigmatization against mental health treatments existed due to the fact that mental illness is an invisible disorder and diagnosing various disorders have proven to be an inexact science, and quite a challenge, given the lack of advanced scientific studies. It has been even more challenging for people who suffer from mental health struggles, having to settle for treatments that were administered on a trial-and-error basis.

So, it comes as a massive relief to many that scientists have now developed a new way of testing blood that can precisely diagnose various mental health conditions! Currently, there are no objective measures such as blood tests that are used in clinical practice, and the available treatments that exist, do not work for everybody. The development of blood tests, as well as the matching of patients with existing and new treatments in a precise, personalized, and preventive fashion, would make a significant difference at an individual and societal level. 

HOW DOES IT WORK?

According to a groundbreaking study by scientists at the Indiana University School of Medicine, mental health diagnosis can now be achieved with a newly developed blood test that will provide information of just how severe a patient’s depression is, the likelihood of them developing severe depression in the future, as well as the risk of developing future bipolar disorder, otherwise known as manic depression. The test also provides information on tailored medication choices for patients.

Led by Alexander B. Niculescu, MD, PhD, Professor of Psychiatry at IU School of Medicine, the study was published on April 8 2021 in the high impact journal Molecular Psychiatry . The work builds on previous research conducted by Niculescu and his colleagues into blood biomarkers that track suicidality as well as pain, post-traumatic stress disorder, and Alzheimer’s disease.

Image Credit: Matthew Ball

“We have pioneered the area of precision medicine in psychiatry over the last two decades, particularly over the last 10 years. This study represents a current state-of-the-art outcome of our efforts,” said Niculescu. “This is part of our effort to bring psychiatry from the 19th century into the 21st century. To help it become like other contemporary fields such as oncology. Ultimately, the mission is to save and improve lives.”

This comprehensive study took place over four years, with over 300 participants recruited primarily from the patient population at the Richard L. Roudebush VA Medical Center in Indianapolis. The team used a careful four-step approach of discovery, prioritization, validation, and testing. While it may sound like too small group for such an important study, the length of time taken to produce such lifechanging results was no small feat.

Niculescu’s team utilized large databases developed from all previous studies in the field, to cross-validate and prioritize their findings. The team observed study subjects in two groups — in high and low mood states — and recorded medical signs and symptoms (also known as biomarkers) found in their blood, and compared the samples with information recorded in a mental health findings database. They were able to find 26 common biomarkers in people with severe depression. Just being able to identify these common ‘traits’ presents a miraculous opportunity for more precise medication prescriptions.

Image Credit: Nathan McDine

From here, researchers validated the top 26 candidate biomarkers in independent cohorts of clinically severe people with depression or mania. Lastly, the biomarkers were tested in additional independent cohorts to determine how strong they were at predicting who is ill, and who will become ill in the future.

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WHAT ARE BIOMARKERS?

“Through this work, we wanted to develop blood tests for depression and for bipolar disorder, to distinguish between the two, and to match people to the right treatments,” said Niculescu. “Blood biomarkers are emerging as important tools in disorders where subjective self-report by an individual, or a clinical impression of a health care professional, are not always reliable. These blood tests can open the door to precise, personalized matching with medications, and objective monitoring of response to treatment.”

In addition to the diagnostic and therapeutic advances discovered in their latest study, Niculescu’s team found that mood disorders are underlined by circadian clock genes–the genes that regulate seasonal, day-night and sleep-wake cycles.

“That explains why some patients get worse with seasonal changes, and the sleep alterations that occur in mood disorders,” said Niculescu.

A HOPEFUL FUTURE FOR MANY

According to Niculescu, the work done by his team has opened the door for their findings to be translated into clinical practice, as well as help with new drug development. Focusing on collaboration with pharmaceutical companies and other doctors in a push to start applying some of their tools and discoveries in real-world scenarios, Niculescu said he believes the work being done by his team is vital in improving the quality of life for countless patients.

Image Credit: Sydney Sims

“Blood biomarkers offer real-world clinical practice advantages. The brain cannot be easily biopsied in live individuals, so we’ve worked hard over the years to identify blood biomarkers for neuropsychiatric disorders,” said Niculescu. “Given the fact that 1 in 4 people will have a clinical mood disorder episode in their lifetime, the need for and importance of efforts such as ours cannot be overstated.”




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