New blood test for anxiety is a breakthrough in mental health diagnosis

Professor of psychiatry Alexander Niculescu, MD, Ph.D., at the Indiana University School of Medicine, has been involved in research about the development of blood tests for pain, depression/bipolar disorder. Building on his past work, his latest study uses similar methods to detect anxiety.

Niculescu and colleagues have developed a blood test for anxiety. According to a press release, the test examines biomarkers that can objectively determine "someone’s risk for developing anxiety, the severity of their current anxiety, and which therapies would likely treat their anxiety the best".

"Many people are suffering from anxiety, which can be very disabling and interfere with daily life," Niculescu, MD, Ph.D., said in a statement. "The current approach is to talk to people about how they feel to see if they could be on medications, but some medications can be addictive and create more problems. We wanted to see if our approach to identifying blood biomarkers could help us match people to existing medications that will work better and could be a non-addictive choice."

The good news is that the blood tests are being developed for wider use by physicians by Indianapolis-based startup MindX Sciences.

The new test could be combined with the other blood tests past research has led to

Discovery, validation, and testing were independent cohorts in the latest study. Participants completed a blood test every three to six months or whenever a new psychiatric hospitalization occurred. Upon the examination of RNA biomarkers in their blood, researchers could identify a participant’s current state of anxiety and match them with medications and nutraceuticals, showing how effective different options could be for them based on their biology, said the release.

"In addition to medications, there are other methods to treat anxiety, such as cognitive behavioral therapy or lifestyle changes. But having something objective like this where we can know what someone’s current state is as well as their future risk and what treatment options match their profile is very powerful in helping people," said Niculescu.

The test can also help evaluate a person's risk of developing higher levels of anxiety in the future and the factors that impact their mental health.

"There are people who have anxiety, and it is not properly diagnosed, then they have panic attacks, but think they're having a heart attack and up in the ER with all sorts of physical symptoms," Niculescu said. "If we can know that earlier, then we can hopefully avoid this pain and suffering and treat them earlier with something that matches their profile."

According to Niculescu, the test could be incorporated into a panel examination as part of a patient's regular wellness visit to prevent any future distress. "Prevention is better in the long run, so our goal is to be able to provide a comprehensive report for patients and their physicians using simply one tube of blood," he said.

The study results were recently published in Molecular Psychiatry.

Study Abstract

Anxiety disorders are increasingly prevalent, affect people’s ability to do things, and decrease quality of life. Due to lack of objective tests, they are underdiagnosed and sub-optimally treated, resulting in adverse life events and/or addictions. We endeavored to discover blood biomarkers for anxiety, using a four-step approach. First, we used a longitudinal within-subject design in individuals with psychiatric disorders to discover blood gene expression changes between self-reported low anxiety and high anxiety states. Second, we prioritized the list of candidate biomarkers with a Convergent Functional Genomics approach using other evidence in the field. Third, we validated our top biomarkers from discovery and prioritization in an independent cohort of psychiatric subjects with clinically severe anxiety. Fourth, we tested these candidate biomarkers for clinical utility, i.e. ability to predict anxiety severity state, and future clinical worsening (hospitalizations with anxiety as a contributory cause), in another independent cohort of psychiatric subjects. We showed increased accuracy of individual biomarkers with a personalized approach, by gender and diagnosis, particularly in women. The biomarkers with the best overall evidence were GAD1, NTRK3, ADRA2A, FZD10, GRK4, and SLC6A4. Finally, we identified which of our biomarkers are targets of existing drugs (such as a valproate, omega-3 fatty acids, fluoxetine, lithium, sertraline, benzodiazepines, and ketamine), and thus can be used to match patients to medications and measure response to treatment. We also used our biomarker gene expression signature to identify drugs that could be repurposed for treating anxiety, such as estradiol, pirenperone, loperamide, and disopyramide. Given the detrimental impact of untreated anxiety, the current lack of objective measures to guide treatment, and the addiction potential of existing benzodiazepines-based anxiety medications, there is a urgent need for more precise and personalized approaches like the one we developed.