Qiu Jianqing, Yu Cheng, Kuang Yalan, Hu Yao, Zhu Ting, Qin Ke, Zhang Wei
West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.
Medical Big Data Center, Sichuan University, Chengdu, China.
Front Psychiatry. 2024 Dec 9;15:1481006. doi: 10.3389/fpsyt.2024.1481006. eCollection 2024.
Psychiatric illness is thought to be a brain somatic crosstalk disorder. However, the existing phenomenology-based Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic framework overlooks various dimensions other than symptoms. In this study, we investigated the associations between peripheral blood test indexes with various symptom levels of major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SCZ) to explore the availability of peripheral blood test indexes.
We extracted cases diagnosed with MDD, BD, and SCZ at West China Hospital from 2009 to 2021, translated their main complaints into Research Domain Criteria (RDoC) symptom severity scores using nature language processing (NLP), and collected their detailed psychiatric symptoms and peripheral blood test results. Then, generalized linear models were performed between seven types of peripheral blood test values with their transformed RDoC scores and detailed symptom information adjusted for age, gender, smoking, and alcohol history.
Several inflammatory-related indexes were strongly associated with the negative valence system (NVS) domain (basophil percentage adjusted = 0.275, lymphocyte percentage adjusted = 0.271, monocyte percentage adjusted = 0.223, neutrophil percentage adjusted = -0.310, neutrophil count adjusted = -0.301, glucose adjusted = -0.287, leukocyte count adjusted = -0.244, NLR adjusted = -0.229, and total protein adjusted = -0.170), the positive valence system (PVS) domain (monocyte percentage adjusted = 0.228, basophil count adjusted = 0.176, and glutamyl transpeptidase adjusted = 0.171), and a wide range of mood, reward, and psychomotor symptoms. In addition, glucose, urea, urate, cystatin C, and albumin showed considerable associations with multiple symptoms. In addition, based on the direction of associations and the similarity of symptoms in terms of RDoC thinking, it is suggested that "positive" mood symptoms like mania and irritability and "negative" mood symptoms like depression and anxiety might be on a continuum considering their opposite relationships with similar blood indexes.
The cross-sectional design, limited symptoms record, and high proportion of missing values in some other peripheral blood indexes limited our findings.
The proportion of high inflammatory indexes in SCZ was relatively high, but in terms of mean values, SCZ, BD, and MDD did not differ significantly. Inflammatory response showed a strong correlation with NVS, PVS, and a range of psychiatric symptoms especially mood symptoms, psychomotor symptoms, and cognitive abilities.
精神疾病被认为是一种脑-躯体相互作用障碍。然而，现有的基于现象学的《精神疾病诊断与统计手册》第五版（DSM-5）诊断框架忽略了症状以外的各个维度。在本研究中，我们调查了外周血检测指标与重度抑郁症（MDD）、双相情感障碍（BD）和精神分裂症（SCZ）各种症状水平之间的关联，以探索外周血检测指标的可用性。
我们提取了2009年至2021年在华西医院被诊断为MDD、BD和SCZ的病例，使用自然语言处理（NLP）将他们的主要诉求转化为研究领域标准（RDoC）症状严重程度评分，并收集他们详细的精神症状和外周血检测结果。然后，在七种外周血检测值与经年龄、性别、吸烟和饮酒史调整后的转化RDoC评分及详细症状信息之间进行广义线性模型分析。
几个与炎症相关的指标与负性价系统（NVS）领域（校正后的嗜碱性粒细胞百分比 = 0.275，校正后的淋巴细胞百分比 = 0.271，校正后的单核细胞百分比 = 0.223，校正后的中性粒细胞百分比 = -0.310，校正后的中性粒细胞计数 = -0.301，校正后的葡萄糖 = -0.287，校正后的白细胞计数 = -0.244，校正后的中性粒细胞与淋巴细胞比值 = -0.229，校正后的总蛋白 = -0.170）、正性价系统（PVS）领域（校正后的单核细胞百分比 = 0.228，校正后的嗜碱性粒细胞计数 = 0.176，校正后的谷氨酰转肽酶 = 0.171）以及广泛的情绪、奖赏和精神运动症状密切相关。此外，葡萄糖、尿素、尿酸、胱抑素C和白蛋白与多种症状显示出相当的关联。此外，基于关联方向和RDoC思维中症状的相似性，考虑到它们与相似血液指标的相反关系，提示躁狂和易怒等“正性”情绪症状以及抑郁和焦虑等“负性”情绪症状可能处于一个连续体上。
横断面设计、有限的症状记录以及其他一些外周血指标中较高的缺失值比例限制了我们的研究结果。
SCZ中高炎症指标的比例相对较高，但就平均值而言，SCZ、BD和MDD之间无显著差异。炎症反应与NVS、PVS以及一系列精神症状尤其是情绪症状、精神运动症状和认知能力密切相关。
