Slashdot is all abuzz about an article submission where a bunch of researchers from Hebrew University in Israel are claiming they have created a simple blood test that can test for “anxiety” within a few hours. I read the article twice and am amazed by a few simple observations:
1. Typically professionals read something like this and look for a journal reference, showing that the researchers took the time to scientifically validate their work. Perhaps it was just shoddy reporting of the “IsraCast” website where this “exclusive” interview was conducted, but no mention of any peer-reviewed research results were noted in the article. Without peer-review, nobody can comment on the quality (or ultimate meaning) of the research being presented.
2. The article makes the following claims:
The problem was that until now the only way to diagnose anxiety disorders was through an examination by a trained psychiatrist. Many people who are reluctant to undergo this examination are left untreated and can continue to suffer for many years.
In fact, a wide range of mental health professionals — including clinical social workers, marriage and family therapists, and psychologists — can all readily make a fairly accurate diagnosis of an anxiety disorder within about an hour. If someone is “reluctant” to undergo such an existing, established method for making a diagnosis, what makes anyone think that taking a few vials of blood is going to be less anxiety-provoking to the average anxiety-ridden individual? I’m not sure I follow the reasoning here.
3. As the article notes:
Her team found more than a 90% correlation between people who were diagnosed with higher than usual anxiety by a psychologist and people with abnormal AChE, BChE and PON levels.
This shows the high validity of existing diagnostic methods, which is handy to know, because the article then notes:
According to Soreq the blood test will be inexpensive, accurate and will take only a few hours to receive the results.
Inexpensive? I’m not sure, but last time I checked anytime you brought in someone to take blood (which in many cases, at least in the U.S., cannot even be done in the doctor’s office but is often relegated to a lab attached to a hospital some place else), have a lab process it (I’ve never heard of a hospital laboratory processing a sample quickly unless it was a life-threatening emergency), and then have a doctor read and interpret the results, you’re looking at a lot more money than it currently costs to do a simple diagnosis of an anxiety disorder. Quick? It currently takes about an hour (sometimes 90 minutes) to do an accurate diagnosis. You can’t beat that with a lab test.
Currently an accurate diagnosis of an anxiety disorder takes less than 90 minutes and can be done for anywhere before $75-150 (assuming your insurance didn’t cover it, but in most cases, it would).
So after reading through this article, it appears this new blood test is:
1. Not something scientifically-accepted yet.
2. Is not less expensive.
3. Is not more accurate.
4. Does not take less time.
5. Involves more professionals, a needle and blood draw, and likely more inconvenience for the client/patient in most circumstances.
I don’t see the benefits, sorry.
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5 Comments to
“Blood Test for Anxiety? Does this help anyone?”
How about an Objective diagnosis?
The Problem comes when a legal issue arises. Either side can always get a trained mental health professional to contradict the Other side’s trained mental health professional.
Always.
A 60 second Pubmed search using the keyword ‘Soreq’ would have found an extract (http://tinyurl.com/79oh5) for:
Sklan EH et al
Acetylcholinesterase/paraoxonase genotype and expression predict anxiety scores in Health, Risk Factors, Exercise Training, and Genetics study.
Proc Natl Acad Sci U S A. 2004 Apr 13;101(15):5512-7. Epub
plus two links (http://tinyurl.com/bjwze & http://tinyurl.com/89zp2) to the full text of this study.
As for your claim that any “mental health professional” can fairly accurately diagnose an anxiety disorder within an hour, perhaps so, but most anxiety or mood disorder patients never get to see one, they consult a PCP who are much less proficient. Even ER doctors miss anxiety disorders most of the time even though a significant number of the people they see are in the ER because of one. Generally, psychiatric disorders are diagnosed when all possible “physical” illnesses have been considered and ruled out after a battery of pathology tests, x-rays and scans. Even then many doctors aren’t completely sure and more importantly, neither are their patients.
I don’t know if this diagnostic test works or not, but if it does I believe it will be of great benefit.
Some may argue there are few objective diagnoses, even in medicine. That’s why legal cases involving health decisions and diseases also often have “dueling” docs. A lab test doesn’t bring an end to the subjective interpretation of test results, questions about blood draws, etc.
60 seconds? Sorry, that wasn’t at all obvious to me (and I’m sure to many others). And while I respect the National Academy of Science, we all know that epubs of such proceedings are hardly of the same (or one might argue, even similar) caliber than the NEJM or such. But it’s good to see something more than a press interview from this team.
I don’t know that most people who have anxiety and mood disorders never get to see a mental health professional. If you could point me to the data that illustrate that, I’d be happy to agree. But to suggest that “most” psychiatric disorders are only diagnosed after all possible physical causes have been ruled out is to live in a very limited world. In every clinical setting I was ever in (community mental health, university counseling, general private practice, etc.), physical ailments were almost never ruled out with any type of formal health exam or physical. That would be the exception, not the rule.
Does anyone know if this actually happened, and if so how a random person in the US can go about getting this test?
The interesting thing from my perspective is that this should very directly tell someone how sensitive they are to certain classes of cholinesterase inhibiting pesticides in the food supply. If the PON1 activity level is low and/or the PON1 genotype encodes for a less effective version, then your cholinesterase will be inhibited when you ingest these pesticides much more so than it would be for someone with a more active and/or effective PON1 genotype/phenotype.
It may be the cholinesterase inhibition resulting from ingesting such pesticides by at-risk individuals that leads to the increased incidence of anxiety identified by Dr. Soreq et. al. For such individuals, strict avoidance of the pesticides by eating only organic foods may help with the anxiety and other symptoms of chronic cholinesterase inhibition.
There are other naturally occuring cholinesterase inhibitors in certain food crops, particularly those in the nightshade family (potato, tomato, peppers, eggplant, etc.). I have been researching why ingestion of such plants causes symptoms of cholinesterase inhibition, like anxiety, for some individuals, but not for others.
So far I have been unable to determine if PON1 also plays a role with those substances. However, Dr. Norman Childers has found that people who have problems with the nightshade toxins seem to also have problems with these pesticides. Being able to start testing the PON1/AChE/BuChE genotype and enzyme levels in people who are known to have problems with the nightshade toxins would be a good start on figuring this out.
The good news is that if people had a test to find out if they are sensitive to these substances, it is possible through diet modification to reduce the symptoms of chronic cholinesterase inhibitor poisioning and benefit from improved quality of life. Now we just need the test. Hopefully this test really exists as a starting point!
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Last reviewed: By John M. Grohol, Psy.D. on 10 Oct 2005
