Department of Psychiatry, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, 519000, China.
Zhuhai Promotion Association of Mental Health, Zhuhai, 519000, China.
BMC Psychiatry. 2023 Oct 16;23(1):755. doi: 10.1186/s12888-023-05204-x.
Since diagnosis of mood disorder heavily depends on signs and symptoms, emerging researches have been studying biomarkers with the attempt to improve diagnostic accuracy, but none of the findings have been broadly accepted. The purpose of the present study was to construct a preliminary diagnostic model to distinguish major depressive disorder (MDD) and bipolar disorder (BD) using potential commonly tested blood biomarkers.
Information of 721 inpatients with an ICD-10 diagnosis of MDD or BD were collected from the electronic medical record system. Variables in the nomogram were selected by best subset selection method after a prior univariable screening, and then constructed using logistic regression with inclusion of the psychotropic medication use. The discrimination, calibration and internal validation of the nomogram were evaluated by the receiver operating characteristic curve (ROC), the calibration curve, cross validation and subset validation method.
The nomogram consisted of five variables, including age, eosinophil count, plasma concentrations of prolactin, total cholesterol, and low-density lipoprotein cholesterol. The model could discriminate between MDD and BD with an area under the ROC curve (AUC) of 0.858, with a sensitivity of 0.716 and a specificity of 0.890.
The comprehensive nomogram constructed by the present study can be convenient to distinguish MDD and BD since the incorporating variables were common indicators in clinical practice. It could help avoid misdiagnoses and improve prognosis of the patients.
由于情绪障碍的诊断严重依赖于症状和体征，因此新兴研究一直在研究生物标志物，试图提高诊断准确性，但没有任何发现得到广泛认可。本研究的目的是构建一个使用潜在的常用血液生物标志物来区分重度抑郁症（MDD）和双相情感障碍（BD）的初步诊断模型。
从电子病历系统中收集了 721 名 ICD-10 诊断为 MDD 或 BD 的住院患者的信息。在进行单变量筛选后，通过最佳子集选择方法选择列线图中的变量，然后使用包含精神药物使用的逻辑回归进行构建。通过接受者操作特征曲线（ROC）、校准曲线、交叉验证和子集验证方法评估列线图的判别、校准和内部验证。
该列线图由五个变量组成，包括年龄、嗜酸性粒细胞计数、催乳素、总胆固醇和低密度脂蛋白胆固醇的血浆浓度。该模型能够区分 MDD 和 BD，ROC 曲线下面积（AUC）为 0.858，敏感性为 0.716，特异性为 0.890。
本研究构建的综合列线图可以方便地区分 MDD 和 BD，因为纳入的变量是临床实践中的常见指标。它可以帮助避免误诊并改善患者的预后。
