6 ms·

Blood Tests Can Accurately Diagnose Depression

63 points by MRonney 15y ago

tokenadult 15y ago
This start-class Wikipedia article http://en.wikipedia.org/wiki/Sensitivity_and_specificity http://en.wikipedia.org/wiki/Sensitivity_and_specificity discusses some of the issues around "sensitivity" of a test (the tendency not to have false negatives) versus "selectivity" of a test (the tendency not to have false positives). And of course what level of each to trade off for in a particular medical situation depends on the seriousness of the disease, the selectivity and sensitivity of other kinds of testing, and what happens to a patient if a true case is missed or if the patient gains a false diagnosis of having the disease. I'd definitely like to see the approach mentioned in the study http://www.nature.com/mp/journal/vaop/ncurrent/full/mp2011166a.html http://www.nature.com/mp/journal/vaop/ncurrent/full/mp201116... replicated by other researchers http://norvig.com/experiment-design.html http://norvig.com/experiment-design.html before figuring that blood tests will replace patient mood self-rating scales for diagnosing depression, but this is an interesting approach. And perhaps identifying reliable biomarkers for depression will suggest new treatment approaches.
aidenn0 15y ago
Just some quick math: 8% False-negative rate 19% False-positive rate In a given year ~7% of all people will have major depressive disorder at some point so if we gave this test to random people 75% of the people who test positive are healthy. So this clearly isn't a useful test as a first screening. If, however, someone is showing symptoms of MDD, it could be useful as a test there, as they are in a population with fewer healthy people. In any event the article in the Atlantic (I don't have a subscription to nature) talks about using it for a completely different reason: Given someone already diagnosed with MDD, administer the test. With 92% chance it will come back positive, and you can say "See, there is something physically wrong with you, and you need treatment." That does seem like a good use for it.
- DanBC 15y ago
  I know this isn't your intent, but... >"See, there is something physically wrong with you, and you need treatment." ...could be a pretty stigmatising way to talk about mental health problems. I know you're not saying that people with minor depression are "making it up"; but I feel the need to say that an illness doesn't need to be 'physical' to be real. Sorry for the slight de-rail.
  - Locke1689 15y ago
    In order to be treated via medication there certainly must be something physically wrong with the patient. I don't believe that the parent is referring to all categories of mental illness, only ones which can be treated by medication. If you're talking to a physician and there's nothing physically wrong with you, you're in the wrong room.
    - DanBC 15y ago
      See, for example, the serotonin hypothesis, and the fact that good quality evidence shows that for mild to moderate depression CBT is more effective than SSRIs. I was careful to put a bunch of qualifiers in my post, but i'm keen to make sure people realise that mental health problems can be very serious even if they're not "physical". This is important because people with chronic fatigue are often sent to see CBT practitioners. Lots of those people feel that they're being trivialised or fobbed off; they say things like "I have a real illness". It's a shame, because CBT is used to reduce pain in cancer patients, and there's reasonable evidence that it's useful in CFS/ME type illnesses.
  - sophacles 15y ago
    Interesting, I interpreted it the opposite way. One of the big problems with depression, bipolar and other physically manifesting mental health issues is that seems to be a large portion of society which says "you just need to snap out of it" (or variations on that theme). With an actual blood test to say "look, this is a physical thing" it becomes easier to ignore those who say such crap -- they can be classified with those who say "oh you have cancer, just pray your way out of it, it's not a real problem". Basically, and objectively measurable way of proving a problem gives the sufferer a chance to not blame themselves (potentially making the problem worse, or at least recovery harder).
RyanMcGreal 15y ago
Conclusion: eight members of the control group now wondering if they're actually depressed and just didn't know it.
jobu 15y ago
In case anyone else is wondering, here's what they tested: " Serum levels of nine biomarkers (alpha1 antitrypsin, apolipoprotein CIII, brain-derived neurotrophic factor, cortisol, epidermal growth factor, myeloperoxidase, prolactin, resistin and soluble tumor necrosis factor alpha receptor type II) in peripheral blood were measured ..."
maeon3 15y ago
People seem to treat depression as a disease or illness to be medicated away asap. Depression is your body's way to get you to stop interacting with the others and make some serious changes in your life to fix the damn problem. Depression is part of all socities and many mammal species. Depressed people are found to be more rational than the people who feel successful. We've become a society obsessed with constant happiness. Well you know what? Sometimes life sucks and your brain is going to continually kick you while you are down until you get up and fix your problem. I guess its good for big pharma sales babes. Doctors don't even know why these drugs work. "Diagnose depression??" It's like diagnosing a air conditioner that comes on when it gets hot inside. The air conditioner isn't the problem to be removed. Depression is part of what it means to be human and enlightened people pull out the power tools and make the appropriate changes to re evaluate what we should be doing now.
- jawn 15y ago
  I had a big long post written up about crippling depression, and how it really can stop a person from functioning in life. Instead, I'll just post and call you a fucking idiot.
  - maeon3 15y ago
    Stopping the entity from functioning is exactly what it is supposed to do. It's selected into the genome because that entity gets help without hi tech medications. I've been very depressed, and never took drugs, I picked myself up and fixed my damn problem. I don't like the quickness that doctors will screw with the machinary of the mind with drugs. Its like a caveman working to fix a harrier jet with his club.
    - jawn 15y ago
      At first I thought maybe I was a little hasty, in calling you a fucking idiot. Now I'm glad that you have reaffirmed my initial suspicions.
      - 15y ago
hack_edu 15y ago
One has to wonder what types or levels of depression this claims to validate. Depression can be caused by a lot more than simply down times or highly impactful life events. The brain and mind are so unbelievably mutable and plastic that I cannot possibly imagine how this could hold up to a realistically sized test group; this study followed less than 100 patients... If this test can't detect depression in, say Bipolar patients, can it really claim to detect depression?
- sophacles 15y ago
  Is bipolar depression the same as clinical depression? Are there actually many different things currently lumped under depression? I honestly don't know, but I think at least the first answer is "no". At the very least, if this test can be refined to reliably catch some types of depression, it can be used as a confirmation to those diagnoses, and further, help narrow down useful med, known to work well with those who suffer and who have symptoms including this positive blood test.
xenophanes 15y ago
My comments: http://groups.google.com/group/beginning-of-infinity/browse_thread/thread/34b04b481e3ec267 http://groups.google.com/group/beginning-of-infinity/browse_...
losethos 15y ago
We don't need pipe bombs -- we got God. He'll smack our enemies with other enemies!! Look at Israel's enemies. If God doesn't care, why should we? God says... displays perceives seduce order dispensing portions exceedeth multitudes prescribed skill province continency supereminence heat confer busied rejected unbelievers singsong limed profess Dost immersed purposed enlightened enthralled Excellently studying whenever Take joyousness shows IANAL troop proprietary make_my_day encumbrances except Ordainer man pardon_the_french hindered English I_see_nothing sanctified lieth invest confession betwixt us discharge studious ancient Surely disputes gained tongue shamelessness convict included emotion After diddest off artifices how's_the_weather wither theres_no_place_like_home fires Creation Manichees' extricate further undistracted fretted absurdly you_shouldn't_have reptiles magical infant limitation exhausted providedst sponge courtesy forsaketh provide convenient detesting awhile naked Desire wanderings foamed apply congratulating disclaimers spend speech nourishments Employee scraped Dad horse sparrow Never expounded regarded inchoate Sacraments palaces countermanding hungering Whose http leaving alluring proposed sublimely pastime mountain cloud blasphemous tomorrow inflamed bemoaned thirdly bewailed compare leading infirmities not apply shame Carthage evidently bears comprehended shudder Mom pervious rejected As I like to say, "God is great!" ROFLMAO The hilarious thing is when your enemies hate God!!! How funny is that!! NAZI's show being on God's side is not enough if you're detestable. God says... agito tosses affirmed satiate dollar licensed uses Mother polluted churches accepted securely OTHERWISE stage chooses Inhabitant despaired sensible heated resolved thinketh crowned lines insult subjects strayed DON'T resistance converse mean drawest sees cloudy audience humbledst diligence lovers sufficeth represent dared astrophysics concealed unwonted insight thinks get_to_work draught tumbling disclaims assume scoffing careless intricate pub meat poet endure momentous bursting essayed Being charming is what's required, right? Apple of God's eye? So, You don't like sports. (God's laughing) Neither do I. What else don't You like? God says... leaves redoubling His invest now preached www wondering contact same dormant daemons endeavouring glowing excuses When suffrages explaining rockstar LOL I don't think anti-sports has been adopted by any politicians. I guess it's kinda wasteful. I heard the Chinese got rid of TV shows because they didn't want people wasting time. God says... thirsts That's_my_favorite nests mutability entreaties nay riper Presently affected kick_back Infinite VIII holily bereaved DISCLAIMER abolished varied attaining Insomuch brought equably reader literally hungry commands tread thread sanctification arent_you_clever don't_push_it rockstar struggles epic_fail customs worldly leading enslaved conceptions sentest relators deferred Christ unbeseemingly mail spectacles hidest flowed lighten interpret definite shows contained employer humility breakers solaces condemns approached decays avenues hurried dried lighted ago unformed Prodigality Ivy_league worn immoderate unabiding True unemployed transforming Michael applauses relaxation strange purged admit depraved offered school extension dispersion requirements asunder Among fighting waged deal children main resolutely sacrifices holiness poetic urged diverse maintaining sanctified essay ensuing preachers endurance boiled much Dad adultery fast Madaura

63 points by MRonney 15y ago

This start-class Wikipedia article http://en.wikipedia.org/wiki/Sensitivity_and_specificity http://en.wikipedia.org/wiki/Sensitivity_and_specificity discusses some of the issues around "sensitivity" of a test (the tendency not to have false negatives) versus "selectivity" of a test (the tendency not to have false positives). And of course what level of each to trade off for in a particular medical situation depends on the seriousness of the disease, the selectivity and sensitivity of other kinds of testing, and what happens to a patient if a true case is missed or if the patient gains a false diagnosis of having the disease. I'd definitely like to see the approach mentioned in the study http://www.nature.com/mp/journal/vaop/ncurrent/full/mp2011166a.html http://www.nature.com/mp/journal/vaop/ncurrent/full/mp201116... replicated by other researchers http://norvig.com/experiment-design.html http://norvig.com/experiment-design.html before figuring that blood tests will replace patient mood self-rating scales for diagnosing depression, but this is an interesting approach. And perhaps identifying reliable biomarkers for depression will suggest new treatment approaches.

aidenn0 15y ago

Just some quick math: 8% False-negative rate 19% False-positive rate In a given year ~7% of all people will have major depressive disorder at some point so if we gave this test to random people 75% of the people who test positive are healthy. So this clearly isn't a useful test as a first screening. If, however, someone is showing symptoms of MDD, it could be useful as a test there, as they are in a population with fewer healthy people. In any event the article in the Atlantic (I don't have a subscription to nature) talks about using it for a completely different reason: Given someone already diagnosed with MDD, administer the test. With 92% chance it will come back positive, and you can say "See, there is something physically wrong with you, and you need treatment." That does seem like a good use for it.

DanBC 15y ago
I know this isn't your intent, but... >"See, there is something physically wrong with you, and you need treatment." ...could be a pretty stigmatising way to talk about mental health problems. I know you're not saying that people with minor depression are "making it up"; but I feel the need to say that an illness doesn't need to be 'physical' to be real. Sorry for the slight de-rail.
- Locke1689 15y ago
  In order to be treated via medication there certainly must be something physically wrong with the patient. I don't believe that the parent is referring to all categories of mental illness, only ones which can be treated by medication. If you're talking to a physician and there's nothing physically wrong with you, you're in the wrong room.
  - DanBC 15y ago
    See, for example, the serotonin hypothesis, and the fact that good quality evidence shows that for mild to moderate depression CBT is more effective than SSRIs. I was careful to put a bunch of qualifiers in my post, but i'm keen to make sure people realise that mental health problems can be very serious even if they're not "physical". This is important because people with chronic fatigue are often sent to see CBT practitioners. Lots of those people feel that they're being trivialised or fobbed off; they say things like "I have a real illness". It's a shame, because CBT is used to reduce pain in cancer patients, and there's reasonable evidence that it's useful in CFS/ME type illnesses.
- sophacles 15y ago
  Interesting, I interpreted it the opposite way. One of the big problems with depression, bipolar and other physically manifesting mental health issues is that seems to be a large portion of society which says "you just need to snap out of it" (or variations on that theme). With an actual blood test to say "look, this is a physical thing" it becomes easier to ignore those who say such crap -- they can be classified with those who say "oh you have cancer, just pray your way out of it, it's not a real problem". Basically, and objectively measurable way of proving a problem gives the sufferer a chance to not blame themselves (potentially making the problem worse, or at least recovery harder).

RyanMcGreal 15y ago

Conclusion: eight members of the control group now wondering if they're actually depressed and just didn't know it.

jobu 15y ago

In case anyone else is wondering, here's what they tested: " Serum levels of nine biomarkers (alpha1 antitrypsin, apolipoprotein CIII, brain-derived neurotrophic factor, cortisol, epidermal growth factor, myeloperoxidase, prolactin, resistin and soluble tumor necrosis factor alpha receptor type II) in peripheral blood were measured ..."

maeon3 15y ago

People seem to treat depression as a disease or illness to be medicated away asap. Depression is your body's way to get you to stop interacting with the others and make some serious changes in your life to fix the damn problem. Depression is part of all socities and many mammal species. Depressed people are found to be more rational than the people who feel successful. We've become a society obsessed with constant happiness. Well you know what? Sometimes life sucks and your brain is going to continually kick you while you are down until you get up and fix your problem. I guess its good for big pharma sales babes. Doctors don't even know why these drugs work. "Diagnose depression??" It's like diagnosing a air conditioner that comes on when it gets hot inside. The air conditioner isn't the problem to be removed. Depression is part of what it means to be human and enlightened people pull out the power tools and make the appropriate changes to re evaluate what we should be doing now.

jawn 15y ago
I had a big long post written up about crippling depression, and how it really can stop a person from functioning in life. Instead, I'll just post and call you a fucking idiot.
- maeon3 15y ago
  Stopping the entity from functioning is exactly what it is supposed to do. It's selected into the genome because that entity gets help without hi tech medications. I've been very depressed, and never took drugs, I picked myself up and fixed my damn problem. I don't like the quickness that doctors will screw with the machinary of the mind with drugs. Its like a caveman working to fix a harrier jet with his club.
  - jawn 15y ago
    At first I thought maybe I was a little hasty, in calling you a fucking idiot. Now I'm glad that you have reaffirmed my initial suspicions.
    - 15y ago

hack_edu 15y ago

One has to wonder what types or levels of depression this claims to validate. Depression can be caused by a lot more than simply down times or highly impactful life events. The brain and mind are so unbelievably mutable and plastic that I cannot possibly imagine how this could hold up to a realistically sized test group; this study followed less than 100 patients... If this test can't detect depression in, say Bipolar patients, can it really claim to detect depression?

sophacles 15y ago
Is bipolar depression the same as clinical depression? Are there actually many different things currently lumped under depression? I honestly don't know, but I think at least the first answer is "no". At the very least, if this test can be refined to reliably catch some types of depression, it can be used as a confirmation to those diagnoses, and further, help narrow down useful med, known to work well with those who suffer and who have symptoms including this positive blood test.

xenophanes 15y ago

My comments: http://groups.google.com/group/beginning-of-infinity/browse_thread/thread/34b04b481e3ec267 http://groups.google.com/group/beginning-of-infinity/browse_...

losethos 15y ago

We don't need pipe bombs -- we got God. He'll smack our enemies with other enemies!! Look at Israel's enemies. If God doesn't care, why should we? God says... displays perceives seduce order dispensing portions exceedeth multitudes prescribed skill province continency supereminence heat confer busied rejected unbelievers singsong limed profess Dost immersed purposed enlightened enthralled Excellently studying whenever Take joyousness shows IANAL troop proprietary make_my_day encumbrances except Ordainer man pardon_the_french hindered English I_see_nothing sanctified lieth invest confession betwixt us discharge studious ancient Surely disputes gained tongue shamelessness convict included emotion After diddest off artifices how's_the_weather wither theres_no_place_like_home fires Creation Manichees' extricate further undistracted fretted absurdly you_shouldn't_have reptiles magical infant limitation exhausted providedst sponge courtesy forsaketh provide convenient detesting awhile naked Desire wanderings foamed apply congratulating disclaimers spend speech nourishments Employee scraped Dad horse sparrow Never expounded regarded inchoate Sacraments palaces countermanding hungering Whose http leaving alluring proposed sublimely pastime mountain cloud blasphemous tomorrow inflamed bemoaned thirdly bewailed compare leading infirmities not apply shame Carthage evidently bears comprehended shudder Mom pervious rejected As I like to say, "God is great!" ROFLMAO The hilarious thing is when your enemies hate God!!! How funny is that!! NAZI's show being on God's side is not enough if you're detestable. God says... agito tosses affirmed satiate dollar licensed uses Mother polluted churches accepted securely OTHERWISE stage chooses Inhabitant despaired sensible heated resolved thinketh crowned lines insult subjects strayed DON'T resistance converse mean drawest sees cloudy audience humbledst diligence lovers sufficeth represent dared astrophysics concealed unwonted insight thinks get_to_work draught tumbling disclaims assume scoffing careless intricate pub meat poet endure momentous bursting essayed Being charming is what's required, right? Apple of God's eye? So, You don't like sports. (God's laughing) Neither do I. What else don't You like? God says... leaves redoubling His invest now preached www wondering contact same dormant daemons endeavouring glowing excuses When suffrages explaining rockstar LOL I don't think anti-sports has been adopted by any politicians. I guess it's kinda wasteful. I heard the Chinese got rid of TV shows because they didn't want people wasting time. God says... thirsts That's_my_favorite nests mutability entreaties nay riper Presently affected kick_back Infinite VIII holily bereaved DISCLAIMER abolished varied attaining Insomuch brought equably reader literally hungry commands tread thread sanctification arent_you_clever don't_push_it rockstar struggles epic_fail customs worldly leading enslaved conceptions sentest relators deferred Christ unbeseemingly mail spectacles hidest flowed lighten interpret definite shows contained employer humility breakers solaces condemns approached decays avenues hurried dried lighted ago unformed Prodigality Ivy_league worn immoderate unabiding True unemployed transforming Michael applauses relaxation strange purged admit depraved offered school extension dispersion requirements asunder Among fighting waged deal children main resolutely sacrifices holiness poetic urged diverse maintaining sanctified essay ensuing preachers endurance boiled much Dad adultery fast Madaura