Bipolar Disorder and Major Depression: A Quantitative, Biochemical Diagnosis is Possible!

Author: Massimo Cocchi

Although there are evidences of a continuing effort by the international psychiatric community to refine the diagnosis of mood disorders, to date, the traditional diagnostic criteria are not enough sensitive in identifying patients with bipolar disorder (BD) from those suffering from major depression (MD), in the first diagnosis. Diagnosis remains mostly late and treatments, that may improve symptoms and quality of life, continue to be preceded by interventions which, in addition to not providing adequate relief, often worsen the BD course, increasing the likelihood of inducing rapid cycles or suicidal behaviour.

Major depressive disorder and other related and nonrelated psychiatric conditions are still characterised and defined by descriptive and non-biological criteria, but it is hoped that we can adequately characterise this and other psychiatric disorders with the addition of new quantitative approaches. Cocchi, Tonello and Gabrielli, as recalled in Open Journal of Depression (2014), have studied platelet membranes of depressed subjects, enlisting profiles of FAs as a possible measure of the membrane status and to determine whether fatty acids could provide indications of diagnostic help between normal subjects and subjects affected by mood disorders.

The results obtained led to the achievement of an important scientific goal: particular and specific composition of platelets FAs correlate significantly with the clinical state of depression and are therefore a fundamental support to the diagnosis of depression and, even more surprisingly, allow discriminating depressed subjects from bipolar ones.

Recently some major events have allowed a movement of thought not only innovative, but of criticism, mainly at a high intellectual and scientific level. It regards the ideological implications of psychiatric diagnosis and the increasing complexity of the nuances that classify the psychiatric disorder, rather than looking at a window that allows, through biological markers, a reliable diagnosis and appropriate care in the first diagnostic instance, unaware that psychiatric diagnosis has dragged on for years about the recognition of bipolar disorder from major depressive disorder, where there is a diagnostic misinterpretation ranging from 40% (Bowden, 2001) to 70% [Tenth World Day for the Prevention of Suicide, Rome, 2012].

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