Background: Bipolar disorder (BD) is a costly, devastating and life shortening mental disorder that is often misdiagnosed, especially on initial presentation. Misdiagnosis frequently results in ineffective treatment. We investigated the utility of a biomarker panel as a diagnostic test for BD.
Methods and findings: We performed a meta-analysis of eight case-control studies to define a diagnostic biomarker panel for BD. After validating the panel on established BD patients, we applied it to undiagnosed BD patients. We analysed 249 BD, 122 pre-diagnostic BD, 75 pre-diagnostic schizophrenia and 90 first onset major depression disorder (MDD) patients and 371 controls. The biomarker panel was identified using ten-fold cross-validation with lasso regression applied to the 87 analytes available across the meta-analysis studies.We identified 20 protein analytes with excellent predictive performance. Importantly, the panel had a good predictive performance to differentiate 12 misdiagnosed BD patients from 90 first onset MDD patients, and a fair to good predictive performance to differentiate between 110 pre-diagnostic BD patients and 184 controls. We also demonstrated the disease specificity of the panel.
Conclusions: An early and accurate diagnosis has the potential to delay or even prevent the onset of BD. This study demonstrates the potential utility of a biomarker panel as a diagnostic test for BD.

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Brain, Behavior, and Immunity
Department of Psychiatry

Haenisch, F., Cooper, J., Reif, A., Kittel-Schneider, S., Steiner, J., Leweke, M., … Bahn, S. (2015). Towards a blood-based diagnostic panel for bipolar disorder. Brain, Behavior, and Immunity, 52, 49–57. doi:10.1016/j.bbi.2015.10.001