Bipolar disorder is a seriously debilitating mental condition that can take a person from the sluggishness of severe depression to super-human energy levels. Many patients with bipolar disorder are often misdiagnosed as having major depressive disorder, or MDD.

This is because bipolar disorder, more often than not, first becomes noticeable when the patient has a bout of depression. Additionally, as bipolar disorder only affects approximately one percent of the population worldwide, clinicians may not enquire as to hypomanic bouts, a hyperactive state that also characterizes the bipolar condition. 

Medicalizing bipolar disorder

Now, a study from researchers at Chongqing Medical University identifies a panel of biomarkers capable of differentiating between bipolar and depressive disorders with unprecedented accuracy.  The team states their study brings researchers closer to an objective test that could one day help distinguish between depression and bipolar disorders. Moreover, their data could also provide far superior diagnostics and treatments which currently rely on patient interviews.

Previous studies show the gold standard diagnostic for bipolar disorder involves structured interviews with patients, however, these have been proven to be subjective and misleading. In contrast, an accurate diagnosis is crucial to quickly getting bipolar patients the treatment they need. 

As the majority of bipolar patients referred to psychiatric clinics are in the depression phase so they do not show symptoms of hypomania, there is a high risk they may be incorrectly diagnosed with manic depressive disorder (MDD).

Hence, improved identification of symptoms and differentiation between these two disorders is important for choosing a suitable treatment and preventive measures. Therefore, the lab set out to develop a medicalized diagnostic proffering an objective way to differentiate between MDD and bipolar disorder.

The current study combines gas chromatography-mass spectrometry and nuclear magnetic resonance to analyze urine metabolites in samples from 126 patients who either had MDD or bipolar disorder.

Medical tests for bipolar disorder

Results show a total of 20 differential metabolites responsible for the discrimination between MDD and bipolar disorder subjects were identified.  Data findings show a panel consisting of six candidate urinary metabolite biomarkers were identified. The lab states their panel correctly distinguished bipolar disorder from MDD subjects with an accuracy of 89-91 percent in the training and testing sets.

The team surmises their results reveal divergent urinary metabolic phenotypes between MDD and bipolar disorder. For the future, the researchers state that the identified urinary biomarkers can aid in the future development of an objective laboratory-based diagnostic test for distinguishing bipolar disorder from MDD patients.

Source: American Chemical Society

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