Towards a blood-based diagnostic panel for bipolar disorder

Frieder Haenisch, Jason D Cooper, Andreas Reif, Sarah Kittel-Schneider, Johann Steiner, F Markus Leweke, Matthias Rothermundt, Nico J M van Beveren, Benedicto Crespo-Facorro, David W Niebuhr, David N Cowan, Natalya S Weber, Robert H Yolken, Brenda W J H Penninx, Sabine Bahn

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: Bipolar disorder (BD) is a costly, devastating and life shortening mental disorder that is often misdiagnosed, especially on initial presentation. Misdiagnosis frequently results in ineffective treatment. We investigated the utility of a biomarker panel as a diagnostic test for BD.

METHODS AND FINDINGS: We performed a meta-analysis of eight case-control studies to define a diagnostic biomarker panel for BD. After validating the panel on established BD patients, we applied it to undiagnosed BD patients. We analysed 249 BD, 122 pre-diagnostic BD, 75 pre-diagnostic schizophrenia and 90 first onset major depression disorder (MDD) patients and 371 controls. The biomarker panel was identified using ten-fold cross-validation with lasso regression applied to the 87 analytes available across the meta-analysis studies. We identified 20 protein analytes with excellent predictive performance [area under the curve (AUC)⩾0.90]. Importantly, the panel had a good predictive performance (AUC 0.84) to differentiate 12 misdiagnosed BD patients from 90 first onset MDD patients, and a fair to good predictive performance (AUC 0.79) to differentiate between 110 pre-diagnostic BD patients and 184 controls. We also demonstrated the disease specificity of the panel.

CONCLUSIONS: An early and accurate diagnosis has the potential to delay or even prevent the onset of BD. This study demonstrates the potential utility of a biomarker panel as a diagnostic test for BD.

Original languageEnglish
Pages (from-to)49-57
Number of pages9
JournalBrain Behavior and Immunity
Publication statusPublished - Feb 2016

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