Blood Test for Anxiety Detection A Breakthrough in Mental Health

A test that detects signs of anxiety in the blood could be a game-changer for mental health care, according to a new study. Nearly one-third of adults in the United States experience an anxiety disorder at some point in their lives, but finding the proper treatment for each unique situation can be a long process. A novel blood test, developed by researchers at the University of Indiana, could help doctors diagnose, treat, and monitor anxiety in patients.

Designing a Blood Test to Detect Anxiety

“Most patients are complex, with some cognitive abnormalities, mood abnormalities, and anxiety. This is a better assessment of all of those areas so you can have a comprehensive view,” said the study’s lead author, Alexander B. Niculescu, MD, PhD, a professor of psychiatry at Indiana University School of Medicine. “It’s not just the traditional approach that we use, putting a single label on a patient.”

The new test—currently available through the start-up MindX Sciences—is the product of two decades of meticulous work. Biomarkers are commonly used to diagnose, monitor, and treat cancer with precision by detecting circulating pieces of RNA and DNA in a liquid biopsy, or blood sample. The presence of certain genes that are either turned on or off can tell doctors how well a person is responding to treatment. However, using the same biopsy approach for mental health conditions has proven to be difficult.

“In psychiatry, everything is more difficult than other areas of medicine because we don’t have tissue,” explained Edwin van den Oord, PhD, director of the Center for Biomarker Research and a professor of precision medicine at Virginia Commonwealth University in Richmond, Virginia, who was not involved in the new research.

For this reason, Dr. Niculescu had to first run a series of studies to determine which genes and specific gene expressions—whether or not the gene is “on” or “off”—are associated with anxiety disorder. “What really mattered was to be accurate,” Dr. Niculescu stated, noting that the team also wanted to understand how to detect a genetic signature that correlates to something happening in the brain, rather than in body tissues, as is the case in cancer.

The Brain-Immune System Connection

The endeavor was plausible since the brain and the immune system are closely linked. “There is a two-way communication between them. The brain affects the immune system, and the immune system affects the brain,” Dr. Niculescu explained. “That’s how we can pick up some peripheral signal that is indicating what is happening in the brain.”

The research team carried out whole genome sequencing on RNA in blood samples to identify which genes and expressions were more prevalent in people with anxiety compared to those without. This data was then compared to genetic information from a larger cohort of patients. A third study further evaluated this data against even more patients.

Dr. Niculescu likened the process to a search engine. The more relevant a gene expression appeared, the higher it moved up the list. Irrelevant ones dropped to the bottom and were ruled out as potential indicators of anxiety.

Clinical Testing and Applications

The biomarkers that rose to the top in those initial studies were tested in a clinical setting to see if they could predict who had anxiety, who would develop anxiety, and whose anxiety was likely to become severe. Using this information, Dr. Niculescu and his team developed an approach using liquid biopsies, similar to those in cancer care, to identify gene expression signatures that track the severity of anxiety and determine which treatments would likely be most effective.

“Having the ability to improve prescribing existing drugs to patients could be a major leap forward,” noted Dr. van den Oord.

Precise Tests Boost Mental Health Treatment

Prescribing treatments, including medication for anxiety disorders, is rarely straightforward. This can lead to months or even years of trying treatments that don’t work for a patient. “It is not always possible for people to self-report on the root cause of their experiences simply through reflecting on these experiences,” explained Leanne Williams, PhD, founding director of the Stanford Center for Precision Mental Health and Wellness and the Stanford PanLab for Precision Psychiatry and Translational Neuroscience at Stanford University.

Dr. Williams compared the recent progress in using objective testing in mental health to advancements in heart disease treatment over the past 75 years. “We have moved from a reliance on self-report for heart disease to the routine use of advanced imaging and other biomarkers to make an accurate diagnosis and to select the right treatment accordingly,” she said.

Future Implications

Dr. Niculescu’s past research has helped develop similar blood tests for pain, depression, bipolar disorder, and post-traumatic stress disorder (PTSD). He stressed that the new blood test for anxiety, and any that may follow, should be used alongside the evaluations doctors already use to diagnose mental health conditions. He sees the tool as especially useful for primary care providers, who see a large number of patients and can easily add an additional blood test to a visit.

Once a person starts treatment, biomarkers can help manage the entire lifecycle of an anxiety disorder. The test also helps recognize anxiety as a condition that is not benign or “all in someone’s head.”

“People suffer in silence,” Dr. Niculescu concluded. “But anxiety is another biological abnormality that can be identified, monitored, and treated.”

Recent advancements in genetic and biomarker research continue to show promise in revolutionizing the diagnosis and treatment of various mental health disorders. Studies indicate that combining these innovative approaches with traditional methods can lead to more personalized and effective treatment plans, ultimately improving patient outcomes and quality of life. As this field evolves, the hope is that mental health care will become as precise and reliable as care for physical health conditions

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