Scientists Are Developing Blood Tests That Could Diagnose Mental Illness

A breakthrough in the way that mental health issues are diagnosed and treated could be on the horizon. A recent study details how biomarkers could be used to diagnose a variety of mental health challenges, potentially making treatment more personalized and effective. Here are all of the details of this promising research.

How Biomarkers Could Improve the Diagnosis and Treatment of Mental Illnesses

Mental health issues are notoriously difficult to diagnose and treat. Prescribing psychiatric medications often involves trying several different treatments to try to find the one that actually works for the patient and their specific needs. This differs from most medical specialties, areas where doctors can lean on objective tests, including bloodwork, biopsies, and imaging, to come to a clear diagnosis. In contrast, mental illnesses have been diagnosed based on outward symptoms reported by the patient.

A paper published by the American Psychiatric Association (APA) in January explained how the medical community could incorporate defined biomarkers into future versions of the Diagnostic Statistical Manual of Mental Disorders (DSM). For context, biomarkers are specific indicators of mental illness that could present themselves on diagnostic tests. The DSM is a manual that gives criteria that clinicians use when diagnosing patients.

The paper emphasized that the use of psychiatric biomarkers has not evolved enough to be used by clinicians. There is still more research needed to prove the metrics are consistent and accurate enough to be rolled out in patient care. There are also a great deal of questions surrounding how the use of biomarkers would impact the cost of care, insurance coverage, and patient privacy concerns.

Doctors currently use a trial-and-error approach to prescribing treatments for mental illnesses. This approach often leads to costly, unnecessary, and ineffective prescriptions. In addition, the use of antidepressants has been shown to exacerbate the illness in rare cases.

Formally incorporating these biomarkers into the DSM would mark a watershed moment for the field. Giving clinicians access to defined test results could accelerate the diagnosis process, resulting in faster and more effective treatment. For instance, a clinician would avoid having to test out different treatments if the patient's personal biology indicates that they would respond better to a specific medication. The biomarkers being included in the DSM would also streamline decisions made by insurers about coverage levels.

Biomarkers Already Used Extensively in Other Medical Disciplines

There is a long history of biomarkers being used to guide health care providers when prescribing treatment in other disciplines. For example, the field of oncology leans heavily on these biomarkers for guidance. In recent years, doctors have also incorporated the use of blood and imaging tests to help diagnose Alzheimer's disease.

The paper published by the APA also touched on ways that psychiatric biomarkers could be leveraged in the future. These potential uses include leaning on biomarkers to determine genetic profiles, test for brain activity, and determine immune markers historically connected to certain psychiatric disorders such as schizophrenia.

Research has already found that about 25% of patients suffering from depression also have elevated levels of C-reactive protein, an inflammatory protein that can be detected through a simple blood test. Scientists have found that patients with elevated levels of this protein tend to respond better to drugs that change dopamine levels in the brain when compared to the use of selective serotonin reuptake inhibitors (SSRIs).

In addition to being able to provide more targeted treatment options, the use of biomarkers to treat mental illnesses could also significantly reduce healthcare costs. These costs tend to skew higher for patients with illnesses that are poorly controlled. A delayed and inaccurate diagnosis is more likely to lead to an increase in hospital visits and other types of unnecessary treatments.

It stands to reason that biomarker testing would naturally reduce costs, as doctors will be able to prescribe effective treatments faster.

A study out of Canada found that the nation's health system could save $956 million over two decades if biomarkers were used to treat depression in adults in British Columbia. Similar results were found in a study by Spanish researchers.

Experts acknowledge that the use of biomarkers to diagnose mental illnesses in the U.S. health care system could cost more in the short term. This is because there will need to be an initial investment in the research and the costs of testing. Insurers may also initially balk at covering expensive biomarker tests until they are safe and effective. Other critics have raised concerns that insurers could discriminate against patients with biological profiles that signal they are at a higher risk of developing a neuropsychiatric issue.

While the use of biomarkers to diagnose and treat mental illness is still uncertain, medical researchers are growing increasingly optimistic about its role in the future. The APA coming on board to embrace this science is a crucial first step in embracing this new technology.

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