Department of Psychosomatics and Psychiatry, School of Medicine, ZhongDa Hospital, Southeast University, No. 87 Dingjiaqiao, Gulou District, Nanjing, 210009, China.
School of Medicine, Southeast University, Nanjing, 210009, China.
Eur Arch Psychiatry Clin Neurosci. 2023 Sep;273(6):1267-1277. doi: 10.1007/s00406-022-01540-3. Epub 2022 Dec 25.
The lack of objective diagnostic methods for mental disorders challenges the reliability of diagnosis. The study aimed to develop an easily accessible and useable objective method for diagnosing major depressive disorder (MDD), schizophrenia (SZ), bipolar disorder (BPD), and panic disorder (PD) using serum multi-protein. Serum levels of brain-derived neurotrophic factor (BDNF), VGF (non-acronymic), bicaudal C homolog 1 (BICC1), C-reactive protein (CRP), and cortisol, which are generally recognized to be involved in different pathogenesis of various mental disorders, were measured in patients with MDD (n = 50), SZ (n = 50), BPD (n = 55), and PD along with 50 healthy controls (HC). Linear discriminant analysis (LDA) was employed to construct a multi-classification model to classify these mental disorders. Both leave-one-out cross-validation (LOOCV) and fivefold cross-validation were applied to validate the accuracy and stability of the LDA model. All five serum proteins were included in the LDA model, and it was found to display a high overall accuracy of 96.9% when classifying MDD, SZ, BPD, PD, and HC groups. Multi-classification accuracy of the LDA model for LOOCV and fivefold cross-validation (within-study replication) reached 96.9 and 96.5%, respectively, demonstrating the feasibility of the blood-based multi-protein LDA model for classifying common mental disorders in a mixed cohort. The results suggest that combining multiple proteins associated with different pathogeneses of mental disorders using LDA may be a novel and relatively objective method for classifying mental disorders. Clinicians should consider combining multiple serum proteins to diagnose mental disorders objectively.
精神障碍缺乏客观的诊断方法,这对诊断的可靠性提出了挑战。本研究旨在开发一种简便易用的客观方法,使用血清多蛋白来诊断重性抑郁障碍(MDD)、精神分裂症(SZ)、双相情感障碍(BPD)和惊恐障碍(PD)。测量了 50 例 MDD 患者(n=50)、50 例 SZ 患者(n=50)、55 例 BPD 患者和 50 例健康对照者(HC)的血清脑源性神经营养因子(BDNF)、VGF(非首字母缩写)、双尾 C 同源物 1(BICC1)、C 反应蛋白(CRP)和皮质醇水平,这些蛋白通常被认为参与了不同精神障碍的不同发病机制。采用线性判别分析(LDA)构建多分类模型,对这些精神障碍进行分类。应用留一法交叉验证(LOOCV)和五折交叉验证来验证 LDA 模型的准确性和稳定性。所有五种血清蛋白均纳入 LDA 模型,当将 MDD、SZ、BPD、PD 和 HC 组进行分类时,该模型显示出 96.9%的高总体准确率。LOOCV 和五折交叉验证(内部研究复制)的 LDA 模型的多分类准确率分别达到 96.9%和 96.5%,表明基于血液的多蛋白 LDA 模型在混合队列中对常见精神障碍进行分类具有可行性。结果表明,使用 LDA 结合与精神障碍不同发病机制相关的多种蛋白可能是一种新颖且相对客观的精神障碍分类方法。临床医生应考虑结合多种血清蛋白客观地诊断精神障碍。