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In a new study from the Danish psychiatry project iPSYCH, researchers have identified genetic risk factors for developing bipolar disorder (BD) and psychoses among people with depression. In the longer term, the results may contribute to ensuring an earlier diagnosis of bipolar disorder and psychoses to receive the correct treatment as quickly as possible.
Bipolar disorder and psychoses such as schizophrenia are serious mental disorders, which often greatly impact a person's life and well-being. In several cases, bipolar disorder and schizophrenia are first diagnosed several years after the disorder's onset. This is associated with an unfavorable prognosis for the course of the disorders.
The sooner the patient gets the correct diagnosis and begins targeted treatment, the better the prognosis. Therefore, researchers aim to identify risk factors that will help psychiatrists reach earlier the diagnosis of bipolar disorder and psychoses.
Depression Often Precedes BD and Psychoses
In many cases, people who develop bipolar disorder or psychoses initially come into contact with mental health services due to experiencing symptoms of depression. Therefore, a research team from iPSYCH set out to examine a dataset consisting of 16,949 people aged 10-35 who had been treated for depression at a psychiatric hospital in Denmark.
“Our goal with the study was to investigate whether genetic factors are associated with an increased risk of developing bipolar disorder or psychosis among patients with depression. This knowledge can potentially be used in clinical practice to identify patients who should be monitored even more closely,” explains the lead author of the research article based on the study, Senior Researcher Katherine Musliner from the National Centre for Register-based Research.
Among the factors the researchers looked into in the study was whether the genetic risk scores for bipolar disorder and schizophrenia — i.e., a person's individual genetic risk of developing these disorders — could help psychiatrists determine which of their patients with depression was at greatest risk of subsequently developing bipolar disorder or a psychosis.
“One thing we discovered was that the genetic risk score for bipolar disorder is associated with an increased risk of developing bipolar disorder and that the genetic risk score for schizophrenia is associated with an increased risk of developing a psychosis among patients who have been diagnosed with depression,” says Katherine Musliner, stressing that the effect of the genetic risk scores was relatively small.
Earlier Diagnosis of BD Still Not Close
Another member of the research group behind the study, Professor Søren Dinesen Østergaard from the Department of Clinical Medicine and Aarhus University Hospital — Psychiatry, emphasizes that caution is needed when interpreting the results.
“At present, the genetic risk scores cannot contribute to the earlier diagnosis of bipolar disorder and psychoses in clinical practice, but it cannot be ruled out that this could be the future scenario. On the other hand, our study confirms that having a parent with bipolar disorder or psychosis is a strong predictor for developing these particular disorders after depression. This underlines the importance of getting information about mental disorders in the family as part of the assessment of people suffering from depression,” he explains.
The results have been published in the American Journal of Psychiatry.
- The study is a register-based study with data from 16,949 people treated for depression at a psychiatric hospital in Denmark in the period from 1994 to 2016.
- The study was carried out in collaboration with researchers from Aarhus University, the University of Copenhagen, Statens Serum Institut, and Johns Hopkins University.
- The Lundbeck Foundation finances the study.
- The scientific article can be read in the American Journal of Psychiatry
Source: Aarhus University
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