Here's an interesting news item from Associated Press. John Kelsoe, a respected psychiatric genetics researcher at U.C. San Diego, has formed a company, Psynomics, to market a genetic test for bipolar disorder. The science of genetic research is ridiculously complicated, but you can learn a lot more by reading this excellent article published in the journal Science (but you have to subscribe to access it). The last time I covered this topic in The Carlat Psychiatry Report was in November 2005, and you can read that issue, including an interesting interview with UCSF's Samuel Barondes here (free full access).The bottom line is that this new test appears to be a bit of a scam, and is based on a notoriously unreliable methodology called "linkage analysis." In psychiatry, this technique has resulted in a litany of dramatic "findings" in psychiatric genetics, most of which have been retracted because of failures to replicate. The Science article quotes Francis Collins, head of the National Human Genome Research Institute, as saying that there is as yet no legitimate genetic marker for bipolar disorder. And efforts to replicate Dr. Kelsoe's marker using the state-of-the-art technique of whole genome scanning have failed.
What we have, then, is a $399 test that will inform some patients that they have double the risk of bipolar disorder. They will respond by believing they have a "bad" gene and will presumably request more intensive psychiatric care, even if they have few symptoms of a mood disorder. Within a year or two, as more data is published, the company will be forced to admit that the test has no merit. Here's hoping Psynomics has thought hard about their refund policy.
Hat tip to: Bernard Carroll, M.D.
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