5 ms·
> Depression’s diagnosis has, though, a worryingly arbitrary quality to it, depending as it does on a doctor’s assessment of a patient’s mood against a checklis
by Blikkentrekker 5y ago
> Depression’s diagnosis has, though, a worryingly arbitrary quality to it, depending as it does on a doctor’s assessment of a patient’s mood against a checklist of symptoms which may be present in different combinations and are often, in any case, subjective. This has led to a search for reliable biochemical markers of the illness. Not only might these assist diagnosis, they may also improve assessments of prognosis and point towards the most effective treatment in a particular case. Now, a group of neuroscientists at Indiana University, in Indianapolis, led by Alexander Niculescu, think they have found a set of markers that can do all this.
Such markers have long existed and been found. This wording suggests that this is the first attempt.
The markers are always only correlative, and obviously it won't happen that, if a patient show the markers, but otherwise show no subjective, he'll be diagnosed with depression, or vice versā, denied such a diagnosis, if he show the symptoms, but not the markers.
> Together, these 13 RNA markers form the basis of a blood test that can not only diagnose depression,
“diagnose”? I doubt that it will replace subjective diagnosis for the aforementioned reason. — the subjective diagnosis will remain the final judgement for a time long to come.
- neuroma 5y agoAgreed. Many psychiatric disorders are a function of personal experience and of collective experience of the person. Whilst I'd welcome more objective and quantitative assessment tools, it feels like blood tests won't ever tell you if a person is depressed. They might suggest a level of inflammation or endocrine stress, and that's a great help, but not equivalent.
- bawolff 5y ago> Many psychiatric disorders are a function of personal experience and of collective experience of the person [Citation needed] That seems like a bold claim relative to our current level of understanding.
- Pyramus 5y agoWhy do you think that? If there is one thing that we do know it is that depression, say, is multifactorial and complex. In very few cases are the reasons only biological (but they do exist). See e.g. https://en.m.wikipedia.org/wiki/Biopsychosocial_model https://en.m.wikipedia.org/wiki/Biopsychosocial_model https://en.m.wikipedia.org/wiki/Learned_helplessness https://en.m.wikipedia.org/wiki/Learned_helplessness
- podgaj 5y agoI get so tired of this dichotomy between nature and nurture. It’s both. Some people have more issues on the nurture side other people have more issues on the nature side. What’s needed is to look at this more holistically. When I realized this I didn’t know how much my environment was affecting my bipolar disorder. Buy matching my nature in my nurture I’ve come along way and getting off of almost all my medications.
- bawolff 5y agoI agree with what you're saying but not the what neuroma is saying (or at least i don't think we know enough to make the claim). I don't think you are saying the same thing.
- tsimionescu 5y agoIf these blood tests do end up being good predictors of depression, it will be very interesting to see how they apply to people who are suffering from similar symptoms that are not clinically depressed - for example, people who have just experienced the death of a loved one.
- satellite2 5y agoThere was actually an exeption for people that lost someone in the DSM. Following long debates they ended up removing it. What seems clear is that in a lot of cases depression seems to be a normal reaction to worsening life conditions and not merely a brain chemicals imbalance. So I think it's wise to remain careful around what can be considered a depression and whether it should be considered a symptom or a disease. https://www.theguardian.com/society/2018/jan/07/is-everything-you-think-you-know-about-depression-wrong-johann-hari-lost-connections https://www.theguardian.com/society/2018/jan/07/is-everythin...
- Pyramus 5y agoLet me add that many psychiatric conditions, more so than physical conditions, are continuous, not binary, with severity changing over time.
- podgaj 5y agoPsychiatric conditions are physical conditions. You cannot have a change in mood with out changes in brain catecholamines. Catecholamines are physical.
- Pyramus 5y agoWhy don't we have valid an reliable biomarkers for depression then? What is a 'normal' level of catecholamines? Not disagreeing that the mental/physical dichotomy is arbitrary.
- 5y ago
- pdamoc 5y ago> “Correlation doesn’t imply causation, but it does waggle its eyebrows suggestively and gesture furtively while mouthing ‘look over there.’” - Randall Munroe The way I see this is that it might be one of those tests that, if they come back positive, indicate that further analysis should be made. A general practitioner might ask for this test and then recommend to the person to see a specialist.
- Blikkentrekker 5y agoWell, as said, the article suggests that this is a novel approach, but similar markers have been known to exist for a while and they still aren't used in diagnosis simply because they're typically not more indicative than simply the patient verbally enunciating “I feel bad.”.
- podgaj 5y agoThis would, however, make a difference with people with mental illness. I make a distinction here between mental health and mental illness. I have been given so many different types of medications to manage so many different types of catecholamines, but they never know which catecholamines are higher low. I have bipolar disorder, it’s genetic, it’s in my family. If they could tell me what I needed to bring me down or take me up that would help me Tremendously.
- scotty79 5y agoThere's a saying that "you don't treat test results". Tests always just inform a diagnosis and usually are not even performed if patient is not suffering any symptoms.
- strken 5y agoIf it's an RNA test, doesn't that mean it's just testing for the genetic predisposition? Unless depression is wholly genetic it seems weird to use an RNA test to diagnose it. Edit: forgot my biology, testing for levels of RNA is probably pretty close to testing protein production.