Hostname: page-component-7c8c6479df-24hb2 Total loading time: 0 Render date: 2024-03-28T21:40:06.178Z Has data issue: false hasContentIssue false

Author's reply

Published online by Cambridge University Press:  02 January 2018

Liz Forty
Affiliation:
Department of Psychological Medicine, School of Medicine, Cardiff University, and Department of Psychiatry, Division of Neuroscience, University of Birmingham
Daniel Smith
Affiliation:
Department of Psychological Medicine, School of Medicine, Cardiff University
Lisa Jones
Affiliation:
Department of Psychiatry, Division of Neuroscience, University of Birmingham
Ian Jones
Affiliation:
Department of Psychological Medicine, School of Medicine, Cardiff University, and Department of Psychiatry, Division of Neuroscience, University of Birmingham
Sian Caesar
Affiliation:
Department of Psychiatry, Division of Neuroscience, University of Birmingham
Carly Cooper
Affiliation:
Department of Psychiatry, Division of Neuroscience, University of Birmingham
Christine Fraser
Affiliation:
Department of Psychological Medicine, School of Medicine, Cardiff University
Katherine Gordon-Smith
Affiliation:
Department of Psychological Medicine, School of Medicine, Cardiff University, and Department of Psychiatry, Division of Neuroscience, University of Birmingham
Sally Hyde
Affiliation:
Department of Psychiatry, Division of Neuroscience, University of Birmingham
Anne Farmer
Affiliation:
MRC SGDP Research Centre, Institute of Psychiatry, London
Peter McGuffin
Affiliation:
MRC SGDP Research Centre, Institute of Psychiatry, London
Nick Craddock
Affiliation:
Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff CF14 4XN. Email: craddockn@cardiff.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Type
Correspondence
Copyright
Copyright © Royal College of Psychiatrists, 2008 

We are in full agreement with Carroll about the limited utility of clinical symptoms for ‘diagnostic tests’ and the consequent importance of efforts to discover biomarkers, endophenotypes or genetic markers. In fact, the main focus of our research is molecular genetic epidemiological investigation of mood disorders and psychoses that has precisely this aim. Reference Green, Raybould, Macgregor, Gordon-Smith, Heron, Hyde, Grozeva, Hamshere, Williams, Owen, O'Donovan, Jones, Jones, Kirov and Craddock1Reference Craddock, Jones, Jones, Kirov, Green, Grozeva, Moskvina, Nikolov, Hamshere, Vukcevic, Caesar, Gordon-Smith, Fraser, Russell, Norton, Breen, St Clair, Collier, Young, Ferrier, Farmer, McGuffin, Holmans, Donnelly, Owen and O'Donovan4 Further, we have a keen interest in using findings to provide biological validators for psychiatric nosology, classification and clinical diagnosis. Reference Craddock and Owen5

However, for the moment, psychiatrists have to make do with the clinical tools available and be alert to diagnostic clues that can help in the delivery of optimal care to their patients. We stand by the statements in our paper: ‘It is commonly, but wrongly, assumed that there are no important differences in the clinical presentation of unipolar and bipolar depression… The clinical features of depression are not, of course, a definitive guide to diagnosis but can help alert the clinician to a possible bipolar course… This is important because optimal management varies between bipolar and unipolar depression.’

References

1 Green, EK, Raybould, R, Macgregor, S, Gordon-Smith, K, Heron, J, Hyde, S, Grozeva, D, Hamshere, M, Williams, N, Owen, MJ, O'Donovan, MC, Jones, L, Jones, I, Kirov, G, Craddock, N. Operation of the schizophrenia susceptibility gene, neuregulin 1, across traditional diagnostic boundaries to increase risk for bipolar disorder. Arch Gen Psychiatry 2005; 62: 642–6.Google Scholar
2 Williams, NM, Green, E, Macgregor, S, Dwyer, S, Norton, N, Williams, H, Raybould, R, Grozeva, D, Hamshere, M, Zammit, S, Jones, L, Cardno, A, Kirov, G, Jones, I, O'Donovan, MC, Owen, MJ, Craddock, N. Variation at the DAOA/G30 locus influences susceptibility to major mood episodes but not psychosis in schizophrenia and bipolar disorder. Arch Gen Psychiatry 2006; 63: 366–73.Google Scholar
3 Wellcome Trust Case Control Consortium. Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls. Nature 2007; 447: 661–78.Google Scholar
4 Craddock, N, Jones, L, Jones, IR, Kirov, G, Green, EK, Grozeva, D, Moskvina, V, Nikolov, I, Hamshere, ML, Vukcevic, D, Caesar, S, Gordon-Smith, K, Fraser, C, Russell, E, Norton, N, Breen, G, St Clair, D, Collier, DA, Young, AH, Ferrier, IN, Farmer, A, McGuffin, P, Holmans, PA, Donnelly, P, Owen, MJ, O'Donovan, MC. Strong genetic evidence for a selective influence of GABA-A receptors on a component of the bipolar disorder phenotype. Mol Psychiatry 2008; in press.Google Scholar
5 Craddock, N, Owen, MJ. Rethinking psychosis: the disadvantages of a dichotomous classification now outweigh the advantages. World Psychiatry 2007; 6: 8491.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.