The British Journal of Psychiatry (2008) 193: 427. doi: 10.1192/bjp.193.5.427
© 2008 The Royal College of Psychiatrists
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Correspondence

Authors' reply

Liz Forty

Department of Psychological Medicine, School of Medicine, Cardiff University, and Department of Psychiatry, Division of Neuroscience, University of Birmingham

Daniel Smith

Department of Psychological Medicine, School of Medicine, Cardiff University

Lisa Jones

Department of Psychiatry, Division of Neuroscience, University of Birmingham

Ian Jones

Department of Psychological Medicine, School of Medicine, Cardiff University, and Department of Psychiatry, Division of Neuroscience, University of Birmingham

Sian Caesar and Carly Cooper

Department of Psychiatry, Division of Neuroscience, University of Birmingham

Christine Fraser

Department of Psychological Medicine, School of Medicine, Cardiff University

Katherine Gordon-Smith

Department of Psychological Medicine, School of Medicine, Cardiff University, and Department of Psychiatry, Division of Neuroscience, University of Birmingham

Sally Hyde

Department of Psychiatry, Division of Neuroscience, University of Birmingham

Anne Farmer and Peter McGuffin

MRC SGDP Research Centre, Institute of Psychiatry, London

Nick Craddock

Department of Psychological Medicine, School of Medicine, Cardiff University, Cardiff CF14 4XN. Email: craddockn{at}cardiff.ac.uk

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.1–4 Further, we have a keen interest in using findings to provide biological validators for psychiatric nosology, classification and clinical diagnosis.5

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
  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.[Abstract/Free Full Text]
    2. 2
  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.[Abstract/Free Full Text]
    3. 3
  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.[CrossRef][Medline]
    4. 4
  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.
    5. 5
  5. Craddock N, Owen MJ. Rethinking psychosis: the disadvantages of a dichotomous classification now outweigh the advantages. World Psychiatry 2007; 6: 84 -91.[Medline]




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