Study offers a promising blood test for depression, bipolar
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While current diagnosis and treatment approaches are largely trial and error, a breakthrough study by Indiana University School of Medicine researchers sheds new light on the biological basis of mood disorders and offers a promising blood test aimed at a precision medicine approach to treatment.

The team's work describes the development of a blood test, composed of RNA biomarkers, that can distinguish how severe a patient's depression is, the risk of them developing severe depression in the future, and the risk of future bipolar disorder (manic-depressive illness). The test also informs tailored medication choices for patients.

This comprehensive study took place over four years, with over 300 participants recruited primarily. The team used a careful four-step approach of discovery, prioritization, validation, and testing. First, the participants were followed over time, with researchers observing them in both high and low mood states--each time recording what changed in terms of the biological markers (biomarkers) in their blood between the two states.

Next, the team utilized large databases developed from all previous studies in the field, to cross-validate and prioritize their findings. From here, researchers validated the top 26 candidate biomarkers in independent cohorts of clinically severe people with depression or mania. Last, 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.

From this approach, researchers were then able to demonstrate how to match patients with medications--even finding a new potential medication to treat depression.

"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 the author. "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."

Molecular Psychiatry
Source: https://doi.org/10.1038/s41380-021-01061-w
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