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    At-Home Bipolar Disorder Test: Help or Hindrance?

    Advocates say it helps doctors make an accurate diagnosis, but critics say more research is needed.

    Diagnosing Bipolar Disorder continued...

    Depression, the other "pole," can be marked by such symptoms as:

    • Feelings of pessimism, sadness, anxiety, or emptiness
    • Lack of interest in any activities that used to bring pleasure, including sex
    • Fatigue or diminished energy
    • Feelings of irritability or restlessness
    • Sleep problems -- too much or too little
    • Weight gain or loss (without trying to) and unusual appetite changes
    • Suicidal thoughts or attempts

    A diagnosis of mania or depression is made based on how many symptoms occur, how frequently, and for how long. Sometimes, the diagnosis is missed altogether; other times, it's mislabeled as simply clinical depression.

    Typically, a doctor takes a careful history, noting the symptoms, and asks about family history.

    Estimates of how many people have bipolar disorder vary widely. The National Institute of Mental Health estimates about 5.7 million Americans over age 18 are affected.

    The Bipolar Test: Second Opinions

    Mental health experts consulted about the new bipolar disorder tests say the science is not yet there.

    "Based on everything we know, this science [behind the bipolar test] is not ready for prime time," says Tom Insel, MD, director of the National Institute of Mental Health. He doesn't rule out the possibility that within a few years and with more discoveries about the genetic roots of mental illness, some ''practical information of value'' might be gotten from these types of tests.

    Of the genetic links, Insel says: "What has been found is an association with a common [genetic] variant that increases your risk of the illness. It confers a very slight increase in risk. But that is a long way from being able to use that single genetic association to make any practical clinical decision."

    "They simply haven't proven an association," says Douglas F. Levinson, MD, the Walter E. Nichols, MD, Professor of Psychiatry at Stanford University School of Medicine. "These tests are based on data which are not considered statistically significant in the field of genetics as a whole," he says, adding that a person's best resource for diagnosing bipolar disorder is still a mental health professional.

    Medical ethicist Arthur Caplan, PhD, agrees that the science isn't there yet. "I think we have companies rushing to take advantage of hype that genomics is ready to go and predict a wide variety of diseases," says Caplan, the Emanuel and Robert Hart Professor of Bioethics at the University of Pennsylvania, Philadelphia. "It's coming, but [it's] not there yet."

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