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Detecting anxiety through blood biomarkers

By Dr Doug Witherspoon - 19th Mar 2023


What else is there to say about anxiety, apart from the fact that it appears to be roaming the streets and striking with impunity at unprecedented levels? No doubt Covid-19 exacerbated the problem and I feel confident that you will have seen your share of presentations that illustrate some of this free-floating angst.   

It was the Latin and Greek physicians of old who identified and classified anxiety as a standalone disorder. The word itself derives from the Latin substantive angor and the corresponding verb ango (to constrict), whilst a cognate word is angustus (narrow). Appropriate, as many people describe their anxiety as manifesting in their throats.

Closer to home, according to Mental Health Ireland, our little island has one of the highest rates (out of 36 countries) of mental health illness in Europe. Some 18.5 per cent of the Irish population were recorded as having a mental health illness, such as anxiety, bipolar disorder, depression, or alcohol/drug use in 2016.

According to the National Institutes of Health in the US, at any given time, approximately 10.7 per cent of the global population suffer with some type of mental health disorder. Anxiety disorder is at the top of this league table, at 3.4 per cent of the population, which equates to 284 million people (2.7 per cent males, 4.1 per cent females).

As you might expect, depression is a close second, at 3.4 per cent (264 million people; 2.7 per cent males, 4.1 per cent females).

However, these figures were compiled in 2017. With lifestyles becoming more stressful, and of course Covid, lockdowns, and general fear an epidemic in itself, it’s fairly safe to assume that these figures are now considerably higher. So the need to spot anxiety early and deal with it appropriately has never been more pressing.

This was the motivation behind the development of a blood test that can, it appears, detect anxiety by examining blood biomarkers. Researchers at the University of Indiana, US, have devised the test that can not only predict a person’s risk of developing anxiety, but can also determine their current level of anxiety and help to suggest which therapies might work best for them. The test has been validated and is currently being developed for wider use.

Of course, biomarkers can change over time, so the test is useful as a predictive tool and to monitor hormonal changes that might affect a person’s mental health.

According to Prof Alexander Niculescu, Professor of Psychiatry at the University of Indiana: “Many people are suffering from anxiety, which can be very disabling and interfere with daily life. The current approach is to talk to people about how they feel to see if they could be on medications, but some medications can be addictive and create more problems. We wanted to see if our approach to identify blood biomarkers could help us match people to existing medications that will work better and could be a non-addictive choice.”

Prof Niculescu has a previous track record in novel blood tests – he previously led research which resulted in blood tests for post-traumatic stress disorder, depression, bipolar disorder, and pain. In the current research, published in Molecular Psychiatry recently, participants completed a blood test every three-to-six months if there was a hospital admission due to mental health issues. Study of the blood biomarkers helped the team to identify a person’s current level of anxiety and matched them with different therapy options.

“In addition to medications, there are other methods to treat anxiety, such as cognitive behavioural therapy or lifestyle changes,” said Prof Niculescu. “But having something objective like this where we can know what someone’s current state is as well as their future risk and what treatment options match their profile is very powerful in helping people.”

He continued: “This is something that could be a panel test as part of a patient’s regular wellness visits to evaluate their mental health over time and prevent any future distress. Prevention is better in the long run, so our goal is to be able to provide a comprehensive report for patients and their physicians using simply one tube of blood.”

It’s a novel development for sure and may help non-psychiatry physicians to shed light on the severity of a patient’s anxiety. However, it’s unlikely that it will fully replace the clinical judgement of the modern-day psychiatrist or referring GP.

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