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Home » Paranoid Schizophrenia

Psychiatric Times. Vol. 28 No. 8
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NEWS 

Blood Tests for Diagnosis of Schizophrenia and Depression?

By Arline Kaplan | August 10, 2011

In his APA presentation, Renshaw described a community-based study designed to validate the biomarker panel for MDD. Thirteen psychiatrists, 1 nurse practitioner, and 1 physician assistant participated in a Clinical Experience Program (CEP) in which they enrolled patients with previously diagnosed MDD or those in whom MDD was suspected.

A total of 95 patients with a range of psychiatric diagnoses—predominantly MDD—were enrolled, and 80 completed the study. In addition, 51 healthy individuals constituted a control group.

For the vast majority of patients, MDDScore results ranged from 6 to 9. Their test scores were highly predictive of the clinical diagnosis they had previously received.

The MDDScore was able to discriminate patients with a clinical diagnosis of MDD from the normal control group, according to Renshaw. The P value for segregating MDD patients from healthy controls was highly significant (P < .0001) over a broad range of male and female patients.

At the time of study entry, all MDD patients were receiving one medication or a combination of medications for their psychiatric disorders, such as escitalopram(Drug information on escitalopram) or duloxetine(Drug information on duloxetine). However, test results did not seem to be affected by the presence of antidepressants, Renshaw explained.

Renshaw told Psychiatric Times that beyond the CEP, he helped Ridge’s founders organize clinical trials of their new technology in Boston and in Seoul, South Korea.

According to Lonna Williams, Ridge Diagnostics’ Chief Executive Officer, the company has completed 5 clinical studies and has 2 ongoing prospective studies for the diagnosis of depression in adults.

“Additionally, we are currently enrolling teenagers in an NIH-funded study for adolescent depression. On conclusion of that study, we plan to make a test available to aid in the diagnosis of depression in adolescents,” she said.

The company also is planning a clinical study to further validate the MDDScore for use in the primary care population; has proposed studies with the US military; and has a biomarker panel for antidepressant treatment efficacy/monitoring being evaluated in 2 clinical studies.

“We do not have a launch date for the therapy-monitoring product at this time but expect it sometime in 2013,” Williams said. “In conjunction with a major academic center in the US, we will begin research on a blood test to aid in diagnosing bipolar disorder.”

The MDDScore test, Williams said, currently costs $745 and is covered by some insurance companies. Payment plans are available for patients without coverage.

In clinical studies and in response to test orders from psychiatrists, other mental health professionals, and physicians treating chronic pain, the company had generated nearly 1000 test results as of early July.

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by Robert Sands | August 12, 2011 11:01 AM EDT

This mechanistically diverse basket of markers with relevant physiologic underpinnings is quite interesting, especially if it has "85% specificity and sensitivity". I have watched many markers come and go with varying degrees of value. I always come back to the clinical reality, which is the basis for judging the markers value in the end. Brain imaging "markers"(patters of blood flow or activity)have teaching value but are generally of little value in the individual case

The "marker" approach will have more use in genetic counseling and working with family members of mentally ill than with those individuals with established mental illness who could care less about their markers, since they already have the full expression clinically. If the markers (basket of markers) could predict penetrance of illness (which is quite variable) that would be a big deal. It would help define the Cannabis/pychosis risk group.
Robert E. Sands, MD

by Stephen Durrenberger | August 15, 2011 11:16 AM EDT

This is certainly a significant breakthrough for psychiatry, however, we must be careful not to draw too sweeping a conclusion from such research. While the blood test for Schizophrenia has great potential in helping identify patients earlier, I am deeply concerned that developing a blood test for MDD will lead to further short-cutting in the evaluation of patients by psychiatrists. It is prudent to note that the blood test CONFIRMED diagnoses that had previously been determined, but DID NOT CHANGE with medication treatment. This could mean that the individuals were biologically predetermined to develop depression, or, more likely, could indicate that medication alone is not adequate treatment for depression. Recent literature reminds us that the doctor patient relationship is far more important that once believed, when measuring response to treatment. The doctor needs to connect with the patient, adequately evaluate the patient, and pay attention to the social factors that lead to and fuel ongoing depression. We have abdicated the treatment of our patient population to primary care practitioners, alternative practitioners, and non-MD therapists for so long, we are losing touch with the essential roots of our profession. Evaluating and treating patients with depression should involve a detailed interview by the psychiatrist, not a 15 minute once-over and a blood test. Based upon the cost of the test, it is clearly more cost-effective to do the former, rather than the latter, so let us hope that the psychiatric community does not further abdicate its position, now to laboratory scientists!

by Daniel Carlat | August 15, 2011 3:30 PM EDT

The depression blood test marketed by Ridge Diagnostics is something of a boondoggle. The two question PHQ-2 test is highly sensitive and specific for depression, and does not cost $745! See my post on this "biomarker" at http://carlatpsychiatry.blogspot.com/2011/08/blood-test-for-depression-really.html.

by Carla Thomas | September 22, 2011 4:53 PM EDT

The use of blood tests to diagnosed neurological disorders (i.e., psychiatric disorders) is long overdue. I agree that such tests will reduce the negative stigma associated with neurological conditions & the perception that those suffering with such disorders can simply change their behavior or receive conditioning techniques to free themselves from the disorder. The change in perception from the mind model to the neurological condition model will increase one's willingness to use medications to improve neurologic function. Now, if we can eliminate the negative stigma associated with terms such as, psychotic & psychiatric, so many people suffering with neurological conditions will become more open to seeking medical support to treat their symptoms. In the end, psychiatric conditions are neurological disorders because they stem from anomalies in genes/cells that impact brain function.






 
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