19 September 2014

Biomarkers of depression

Clinical depression: diagnosis by a drop of blood

Northwestern University Medical News: First Blood Test to Diagnose Depression in AdultsPsychiatry specialists from Northwestern University (Chicago, USA) Work by Redei et al.

Blood transcriptomic biomarkers in adult primary care patients with major depressive disorder underlying cognitive behavioral therapy is published in the open access journal Translational Psychiatry.

Clinical depression (major depressive disorder, BDR) is a mental illness that, according to experts, approximately every sixth inhabitant of the Earth faces. Symptoms include a constant decrease in mood, depression, loss of interest in the environment and pleasure, weight loss, cognitive impairment, recurrent thoughts of suicide or suicidal attempts, and others. The currently used method of detecting BDR is based on the subjective feelings of the patient, his ability to verbally express them and the ability of the doctor to interpret them correctly, which affects the accuracy of diagnosis.

A group led by Professor Eva Redei has been developing a test for several decades that allows for an objective, scientifically based, independent of personal assessments diagnosis of BDR. Scientists were able to identify a panel of genetic biomarkers associated with BDR. We are talking about the level of representation in the blood of RNA molecules formed as a result of the expression (work) of the corresponding genes. Previously, Redei and her colleagues have already conducted successful clinical trials of the test on adolescents. Now scientists have managed to identify nine biomarkers specific to adult patients.

The test involved 32 patients aged 21 to 79 years who had previously been diagnosed with clinical depression by the usual method, and 32 non-depressed participants in the control group. At the start of the study, the levels of biomarkers in the blood were determined in all participants, and they differed significantly in the BDR sufferers and the control group. Then the patients underwent an 18-week course of cognitive behavioral therapy (one of the varieties of psychotherapy). After its completion, it became possible to separate patients who responded positively to therapy and, according to their estimates, no longer experienced symptoms of depression from those on whom the therapy did not have the proper effect, according to the changed levels of biomarkers. Thus, for the first time it was possible to obtain a biological indicator of the success of psychotherapy, the authors note.

In addition, the test allows you to predict in advance, according to a certain combination of biomarker levels in the blood, whether the condition of patients will improve in response to psychotherapy or not. Another advantage of the test is the possibility of identifying in each individual case a predisposition to the return of depression after the patient reaches remission of his condition. The concentration in the blood of three of the nine biomarkers in this case remains different from the norm. The high risk of relapse detected by the blood test will mean the need for closer monitoring of the patient's condition and the selection of more individualized therapies.

"This means that now we have a laboratory analysis for depression, which gives the same definite, scientifically-based result as, for example, an analysis of cholesterol levels in the blood," said Redei. "The test we have developed raises the diagnosis of mental disorders to the level of the 21st century and for the first time provides patients suffering from depression with access to personalized medicine."

Currently, the Redei group is planning to conduct more large-scale clinical trials of the test, and is also going to check whether it can be used to detect not only BDR, but also other types of depression.

Portal "Eternal youth" http://vechnayamolodost.ru19.09.2014

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