Tuesday, October 31, 2023

Blood test for bipolar disorder will never be available

It worries me that organisations acting on behalf of service users and their representatives can be so taken in by biomedical psychiatry. For example, I have recently received an email from Bipolar UK about a JAMA Psychiatry brief report that there could be a simple blood test to diagnose bipolar disorder (see MailOnline report). Simon Kitchen, their CEO, is quoted as saying, such a blood test "would be immeasurably beneficial" for the bipolar community. He does qualify this by saying, “we would like to understand more about likely timescales and implementation. When will this blood test be available?" What concerns me, though, is that there is no questioning about whether this is even a realistic possibility.

I’ve always said the wish to find a physical basis for mental illness will never go away completely (see eg. previous post). The diagnosis of bipolar disorder, like any other psychiatric diagnosis, is not an exact science. There are even issues about whether bipolar disorder, certainly in the wider diagnostic sense it has come to be used over recent years, amounting, essentially, to seeing bipolar disorder as mood instability (see eg. another previous post), can be separated from major depressive disorder (see eg. yet another previous post). As I wrote in my book review:-

There was a time when psychiatry would not have made so much of the difference of whether depressed people also had manic episodes or not. With the development of mood stabilizing medication, this has come to matter more and the concept of bipolar disorder has even been broadened to make more people eligible for these new medications.

As I said in the title of a previous post, psychiatric practice is too based on speculation. It would be helpful if Bipolar UK did not encourage this. However trite it may be to say, people with a diagnosis of bipolar disorder need to be understood as people like everyone else, responding in an intelligible, maybe even reasonable way, to an unreasonable social situation. It may seem attractive to think there will be a blood test to detect the disorder but that’s pie in the sky, not science.

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