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Published online by Cambridge University Press:  02 January 2018

Liz Forty ,
Daniel Smith ,
Lisa Jones ,
Ian Jones ,
Sian Caesar ,
Carly Cooper ,
Christine Fraser ,
Katherine Gordon-Smith ,
Sally Hyde  and
Anne Farmer
...Show all authors
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: [email protected]
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Abstract

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Type
Correspondence
Information
The British Journal of Psychiatry , Volume 193 , Issue 5 , November 2008 , pp. 427
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 Craddock1–Reference 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

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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: 84–91.Google Scholar
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