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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.

The Bipolar Test: Second Opinions continued...

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."

A more powerful predictor would be to ask a doctor to look at your family history in more detail, says Ken Duckworth, MD, medical director of the National Alliance on Mental Illness and assistant professor at Harvard Medical School. "I would pay that $399 for the best mood disorders consultant in your city. Ask me in five years and perhaps I would have a different take on this.

"We don't actually know enough about the brain to consider genetic testing to be definitive at this point for any mental illness," he says.

The test could have potential harm, says Clarence H. Braddock III, MD, MPH, associate professor of medicine and director of clinical ethics for the Stanford Center for Biomedical Ethics. For instance, a doctor might erroneously diagnose someone as bipolar based on the genetic test results. "There are a lot of consequences [associated with an incorrect diagnosis]," he says, such as medication costs and side effects and the social stigma associated with mental illness.

In a general statement addressing all at-home genetic tests, the Federal Trade Commission notes that "a healthy dose of skepticism may be the best prescription."

A Patient's Perspective

The home test wasn't available when Ross Szabo, now 29, was diagnosed with bipolar disorder at age 16. He probably wouldn't have taken advantage of the test, he tells WebMD, because his diagnosis, based on symptoms, was "pretty clear."

Whether consumers use the test or not, says Szabo, who works as director of youth outreach for the National Mental Health Awareness Campaign, "you can't look at the diagnosis as the end of the problem. It's really only the beginning. Finding the right diagnosis is important. Accepting that diagnosis is more important.''

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Reviewed on June 04, 2008

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