The sudden shift between mania and depression is the hallmark symptom of bipolar disorder. People with bipolar disorder experience shifts in energy levels and moods randomly, which could endanger them, and an accurate diagnosis of the condition can potentially save their lives. As of now, a reliable blood test is being explored to develop a specific diagnostic test for the mental condition.

Biomarkers of Vitamin D in Blood Could Provide Reliable Test

Psychologists, psychiatrists, and other mental health specialists diagnose bipolar disorder based on the clinical presentation of symptoms. However, symptoms of BD can easily be mistaken for other mental illnesses, such as depression and schizophrenia. That often leads to sufferers of BD to become undiagnosed and untreated for several years. They also likely to be misdiagnosed with a condition that they never really have, but only mimics one or more symptom, which is why some of them do not get better with their medications.

"It is estimated that two to seven percent of people in the United States suffer from bipolar disorder. Almost 10 million people will develop the illness sometimes during their lives. About half of these will never receive the correct diagnosis or treatment," Dr. Wes Burgess, a psychiatrist in California, wrote in his book, "The Bipolar Handbook: Real-Life Questions with Up-to-Date Answers."

To develop a reliable test, biological markers that contribute to brain inflammation in the bloodstream must be identified. The reason behind the logic is that previous studies have found that elevated levels of inflammatory markers are associated with psychiatric problems such as depression and bipolar disorder. A blood test that can indicate the presence of BD or other mental illness would prove to be useful to many people, particularly children.

"Childhood bipolar disorder can be very difficult to distinguish from other disorders, especially in youth with certain types of depression," explained Barbara Gracious, the lead co-author of the study and an associate professor of clinical psychiatry and nutrition at The Ohio State University.

In the search for biomarkers of BD, the researchers conducted a pilot study at Harding Hospital of Wexner Medical Center at OSU. The pilot study involved 12 children diagnosed with bipolar disorder, 11 children diagnosed with the major depressive disorder, and 13 children who had no mood disorders. They tested vitamin D and its potential as a biomarker of the mental condition. They found that the inflammatory markers of vitamin D in blood had no significant connection to BD.

Trying a different angle, the researchers used a technique wherein they created a biological bait to find any factors relevant to inflammation. The bait discovered that the binding protein in vitamin D has a potential to be a diagnostic target for BD.

When they tested the binding protein, they found that it was more expressed by 36 percent in children with bipolar disorder, compared to children who had no mood disorder.

"We wanted to look at factors that could be involved in mood disorders on a cellular level and that could be easily found in the blood. We want to help psychiatrists and other doctors diagnose children early and accurately. Once bipolar disorder progresses, it is more challenging to treat," explained Ouliana Ziouzenkova, the lead author of the study and an associate professor of human nutrition at Ohio State.

Ziouzenkova is seeking support to conduct a larger study using the blood that has been collected already from patients with BD, including adults.

Bipolar Disorder: Current Diagnosis and Available Treatment Options

Bipolar disorder is one of the ten leading causes of disability in the world, according to the World Health Organization. Many people around the world suffer from the mental condition including 390,000 people in Canada, 238, 000 people in Australia, and 723,000 people in the United Kingdom, and most of them are left undiagnosed.

Diagnosis of the mental condition depends on the following factors:

- Frequency, length, and severity of mood swings, such as highly elevated attitude or very depressed feeling.

- Whether it is an elevated or depressed episode, therapists also need to determine if the mood swings have been accompanied by irritability or hopelessness.

- Background of the person, such as family and medical history, are also included in the assessment process.

- Impairment of the cognitive function, such as memory and reasoning, are important in diagnosing mental health issues.

When a person is diagnosed with bipolar disorder, the therapist introduces the possible treatment options. The goal of the treatment of BD is to reduce the frequency, length, and severity of symptoms. Treatment options include psychotherapy, such as cognitive behavioral therapy and psychoeducation, and prescribed medications, such as antidepressants and mood stabilizers.

Depending on the degree of the condition, the therapist may also go for other treatment options such as the electroconvulsive therapy that uses shock to treat symptoms and sleep medications to help patients sleep better.

[메디컬리포트=Ralph Chen 기자]