Speeding up diagnoses

New research suggests a simple urine test could help spot conditions including bipolar disorder, ADHD and anorexia much sooner, easing pressure on health services where diagnoses can currently take months – even years.

In a cross-departmental study led by researchers from the Department of Chemical Engineering and Biotechnology (CEB) and the Yusuf Hamied Department of Chemistry, the team identified 67 urinary markers linked to psychiatric conditions – 21 of them unique to a single disorder. These included altered levels of vitamin B6 (pyridoxal) in anorexia, N,N-dimethylglycine in ADHD, and changes in creatine and tyrosine linked to bipolar disorder and schizophrenia, respectively.

The research team used a Mendelian randomisation approach – a genetic method that mimics a genomic clinical trial – to identify causal links between psychiatric conditions and the chemical markers in urine. This approach avoids the time and cost of traditional lab-based biomarker screening.

“By using existing data, we’ve identified markers that could one day support clinical decisions and bring help to people much earlier,” said first author, and PhD student, Jihan Zaki. “The next step is to test these candidates in real-world clinical trials.”

Diagnosing psychiatric conditions remains one of the most complex and drawn-out processes in UK healthcare. People with bipolar disorder wait over nine years on average for a diagnosis, while conditions like ADHD and anorexia – particularly in children and young people – often involve lengthy delays before assessment and treatment. The NHS has acknowledged these challenges, with many people waiting months or even years to access specialist services.

“A urine test is quick, non-invasive and routine procedure in healthcare,” said Professor Sabine Bahn, corresponding author and head of the Cambridge Centre for Neuropsychiatric Research. “If these findings hold up in clinical trials, we could offer GPs and mental health teams a practical tool to support earlier diagnosis – and reduce pressure on overstretched NHS services.”

Professor Oren Scherman, co-corresponding author with the Yusuf Hamied Department of Chemistry, added: “This kind of cross-disciplinary research shows how chemistry, biotechnology and data science can come together to address major challenges in healthcare.”

This announcement follows the first part of the research, published in Scientific Reports on 1 July. The latest findings are now published as a pre-print in BMC Psychiatry, building on the earlier study and highlighting specific biomarker candidates for future clinical trials. The research builds on the group’s recent work to identify blood-based markers for bipolar disorder – as well as the department’s ongoing work to develop a urine-based test for early lung cancer detection, another non-invasive approach aiming to save lives and reduce NHS demand.