克索瑞波的單心宅

文章轉錄自Medical News Today（點此連結）；文章主要論述：荷蘭研究團隊嘗試經由驗血（血液測試）來診斷精神病症，如憂鬱症；精神醫學不像其它醫學領域有診斷性的驗血測驗，研究者試著經由分析基因組型以區辨出重度憂鬱患者和健康者兩大族群，文中亦指出這概念初想還只跨出第一步，驗血雖然不會產生偏見，但是測驗的敏感度和準確性目前仍無法在精神醫學上提供確切診斷與治療判斷。第一、古希臘的希波克拉底（Hippocrates）曾提出體液學說以說明人類四種體液的平衡會影響健康與氣質性格（請參考維基百科：Humorism），舉例來說：憂鬱症即是和黑膽汁（black bile）有關（其實中醫應也有如此的說法）；第二、測驗同時要考量信度（reliability）和效度（validity），使用驗血來診斷重度憂鬱症的測驗現階段恐為有穩定信度但卻沒有效度；第三、假想這驗血研究真的成功，你會願意紮幾針來監測自己目前的精神狀態嗎？或，你願意政府、健保制度推廣此驗血篩選來檢測你的憂鬱情緒，並加以記錄在你的健保晶片卡上？

Could A Diagnostic Blood Test Be Created For Depression?

25 Jul 2010

Psychiatry, unlike many other areas of medicine, lacks diagnostic blood tests. Blood tests have been extremely useful in helping doctors make medical diagnoses and aiding them in treatment options for conditions and diseases in most medical fields.

An article in Biological Psychiatry reports that Dutch researchers may eventually generate blood tests for psychiatric conditions, such as depression.

Under increasingly intensive research by scientists are the studies of:

    ‧ Variations in DNA (genes) that can be extracted from blood cells
    ‧ Genomics like proteomics, the measurement of the levels of specific proteins in the blood
    ‧ Gene expression profiling, which measure the levels of RNA produced from DNA as an indication of the activity of specific genes.

Dutch researchers evaluated blood gene expression profiles in two groups of people:

    ‧ Patients diagnosed with major depressive disorder (MDD)
    ‧ Healthy individuals

They identified a set of 7 genes in whole blood that could tell the un-medicated MDD patients from the healthy ones.

Dr. Sabine Spijker, one of the authors, said:" This is a first, but major step in providing a molecular diagnostic tool for depression. "

Experts say this type of diagnostic test would be especially useful for diagnosing mental health disorders when it is more difficult to have a conversation with the patient; it would also be unbiased.

The writers add that blood tests of this type may also help in reducing the stigma associated with mental health illness, conditions, and problems.

Dr. John Krystal, Editor of Biological Psychiatry cautions:" It is far too early to be confident that gene expression profiling will lead us to diagnostic or prognostic tests for depression. However, the objective of this line of research is extremely important. In the past, many types of tests have been explored as potential diagnostic markers, but they all have failed to have sufficient sensitivity and specificity to guide doctors in making psychiatric diagnoses or choosing between treatments. I look forward to seeing whether the patterns of gene expression profiling are replicable and diagnostically specific as multiple groups report their findings."

Hopefully, say the authors, this study may be a stepping stone towards finding markers that may predict treatment outcome and recurrence.

"Stimulated Gene Expression Profiles as a Blood Marker of Major Depressive Disorder"
Sabine Spijker, Jeroen S. Van Zanten, Simone De Jong, Brenda W.J.H. Penninx, Richard van Dyck, Frans G. Zitman, Jan H. Smit, Bauke Ylstra, August B. Smit, Witte J.G. Hoogendijk
Biological Psychiatry, Volume 68, Issue 2, 15 July 2010, Pages 179-186

Could A Diagnostic Blood Test Be Created For Depression? 25 Jul 2010    Psychiatry, unlike many other areas of medicine, lacks diagnostic blood tests. Blood tests have been extremely useful in helping doctors make medical diagnoses and aiding them in treatment options for conditions and diseases in most medical fields. An article in Biological Psychiatry reports that Dutch researchers may eventually generate blood tests for psychiatric conditions, such as depression. Under increasingly intensive research by scientists are the studies of: Variations in DNA (genes) that can be extracted from blood cells Genomics like proteomics, the measurement of the levels of specific proteins in the blood Gene expression profiling, which measure the levels of RNA produced from DNA as an indication of the activity of specific genes. Dutch researchers evaluated blood gene expression profiles in two groups of people: Patients diagnosed with major depressive disorder (MDD) Healthy individuals They identified a set of 7 genes in whole blood that could tell the un-medicated MDD patients from the healthy ones. Dr. Sabine Spijker, one of the authors, said: This is a first, but major step in providing a molecular diagnostic tool for depression. Experts say this type of diagnostic test would be especially useful for diagnosing mental health disorders when it is more difficult to have a conversation with the patient; it would also be unbiased. The writers add that blood tests of this type may also help in reducing the stigma associated with mental health illness, conditions, and problems. Dr. John Krystal, Editor of Biological Psychiatry cautions: It is far too early to be confident that gene expression profiling will lead us to diagnostic or prognostic tests for depression. However, the objective of this line of research is extremely important. In the past, many types of tests have been explored as potential diagnostic markers, but they all have failed to have sufficient sensitivity and specificity to guide doctors in making psychiatric diagnoses or choosing between treatments. I look forward to seeing whether the patterns of gene expression profiling are replicable and diagnostically specific as multiple groups report their findings. Hopefully, say the authors, this study may be a stepping stone towards finding markers that may predict treatment outcome and recurrence. "Stimulated Gene Expression Profiles as a Blood Marker of Major Depressive Disorder" Sabine Spijker, Jeroen S. Van Zanten, Simone De Jong, Brenda W.J.H. Penninx, Richard van Dyck, Frans G. Zitman, Jan H. Smit, Bauke Ylstra, August B. Smit, Witte J.G. Hoogendijk Biological Psychiatry, Volume 68, Issue 2, 15 July 2010, Pages 179-186