Maes Michael, Zhou Bo, Jirakran Ketsupar, Vasupanrajit Asara, Boonchaya-Anant Patchaya, Tunvirachaisakul Chavit, Tang Xiaoou, Li Jing, Almulla Abbas F
Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China; Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, Thailand; Cognitive Impairment and Dementia Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria; Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria; Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, South Korea.
Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China.
J Affect Disord. 2024 Apr 1;350:728-740. doi: 10.1016/j.jad.2024.01.150. Epub 2024 Jan 20.
The binary major depressive disorder (MDD) diagnosis is inadequate and should never be used in research.
The study's objective is to explicate our novel precision nomothetic strategy for constructing depression models based on adverse childhood experiences (ACEs), lifetime and current phenome, and biomarker (atherogenicity indices) scores.
This study assessed recurrence of illness (ROI: namely recurrence of depressive episodes and suicidal behaviors, SBs), lifetime and current SBs and the phenome of depression, neuroticism, dysthymia, anxiety disorders, and lipid biomarkers including apolipoprotein (Apo)A, ApoB, free cholesterol and cholesteryl esters, triglycerides, high density lipoprotein cholesterol in 67 normal controls and 66 MDD patients. We computed atherogenic and reverse cholesterol transport indices.
We were able to extract one factor from a) the lifetime phenome of depression comprising ROI, and traits such as neuroticism, dysthymia and anxiety disorders, and b) the phenome of the acute phase (based on depression, anxiety and quality of life scores). PLS analysis showed that 55.7 % of the variance in the lifetime + current phenome factor was explained by increased atherogenicity, neglect and sexual abuse, while atherogenicity partially mediated the effects of neglect. Cluster analysis generated a cluster of patients with major dysmood disorder, which was externally validated by increased atherogenicity and characterized by increased scores of all clinical features.
The outcome of depression should not be represented as a binary variable (MDD or not), but rather as multiple dimensional scores based on biomarkers, ROI, subclinical depression traits, and lifetime and current phenome scores including SBs.
二元重度抑郁症（MDD）诊断并不充分，绝不应在研究中使用。
本研究的目的是阐明我们基于童年不良经历（ACEs）、终生和当前表型以及生物标志物（动脉粥样硬化指数）得分构建抑郁症模型的新型精准法模型策略。
本研究评估了67名正常对照和66名MDD患者的疾病复发情况（ROI：即抑郁发作和自杀行为的复发）、终生和当前的自杀行为以及抑郁症、神经质、心境恶劣、焦虑症的表型和脂质生物标志物，包括载脂蛋白（Apo）A、ApoB、游离胆固醇和胆固醇酯、甘油三酯、高密度脂蛋白胆固醇。我们计算了动脉粥样硬化和逆向胆固醇转运指数。
我们能够从以下方面提取一个因素：a）包括ROI以及神经质、心境恶劣和焦虑症等特征的抑郁症终生表型；b）急性期表型（基于抑郁、焦虑和生活质量得分）。偏最小二乘法分析表明，终生+当前表型因素中55.7%的方差可由动脉粥样硬化增加、忽视和性虐待来解释，而动脉粥样硬化部分介导了忽视的影响。聚类分析产生了一组患有重度情绪障碍的患者，通过动脉粥样硬化增加进行外部验证，并以所有临床特征得分增加为特征。
抑郁症的结果不应表示为二元变量（是否为MDD），而应表示为基于生物标志物、ROI、亚临床抑郁特征以及包括自杀行为在内的终生和当前表型得分的多维度分数。
