A New Way of Diagnosing Psychiatric Conditions

A study of 37 participants has shown that cortisol can effectively be measured in our ear wax with a new type of swab which won't damage the eardrum. Cortisol is a steroid hormone that has a very important role in helping the body respond to stress. When a stressful situation occurs, cortisol levels rise, and the hormone is released into the bloodstream. The exact role of cortisol in mental disorders is not yet fully understood, however we know that chronic stress and elevated cortisol levels increase one's risk for depression and anxiety.

If this method does prove to be successful, it may help the 1 in 4 people who are affected by mental health problems. It will enable easy and painless diagnosis, which is essential in excellent patient care.

Dr Herane-Vives, a psychiatrist at University College London Institute of Cognitive Neuroscience is attempting to find a new and improved scientific method of diagnosing mental health disorders. Currently the diagnosis of psychiatric conditions is very subjective, which psychiatrists have tried to combat by creating diagnostic manuals like ‘The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition’(DSM-5), which is a manual for assessment and diagnosis of mental disorders.

However, these manuals have a huge amount of overlap in symptoms between diagnoses and they tell us little about the individual patient and what treatment they need. This causes delays in giving the people living with a mental illness the help they need.

Although unconventional, using ear wax as an indicator for cortisol levels can be an alternative to traditional blood tests or hair analysis. Taking a blood tests could potentially be a stressful event for the patient, and this could lead to false positives, whereas assessing cortisol levels through hair analysis which includes cutting 3cm strands of hair is not a procedure many patients look forward to.

The hormone can be stored in the wax for a long time which helps in getting an accurate measurement. The hope for the future is that this will help to monitor depression and stress-linked conditions.

However, we are still a long way from knowing if this method of diagnosis can be an objective biological measure, as not many clinical studies on cortisol and psychiatric disorders have been carried out since the late 80s (Meltzer, H.Y 1989)-early 2000s (AH Young 2004). This study (Dr Herane-Vives, 2020) was also carried out on a small scale and there have not yet been any follow up studies, so we do not know if there are any contraindications.