TY - JOUR PY - 2021// TI - A machine learning algorithm to differentiate bipolar disorder from major depressive disorder using an online mental health questionnaire and blood biomarker data JO - Translational psychiatry A1 - Rustogi, Nitin A1 - Martin-Key, Nayra A. A1 - Mirea, Dan-Mircea A1 - Barton-Owen, Giles A1 - Han, Sung Yeon Sarah A1 - Tomasik, Jakub A1 - Bahn, Sabine A1 - Cowell, Dan A1 - Bell, Emily A1 - Olmert, Tony A1 - Lago, Santiago G. A1 - Friend, Lauren V. A1 - Farrag, Lynn P. A1 - Schei, Thea S. A1 - Metcalfe, Tim A1 - Tuytten, Robin A1 - Thomas, Grégoire A1 - Eljasz, Pawel A1 - Ozcan, Sureyya A1 - Cooper, Jason D. SP - e41 EP - e41 VL - 11 IS - 1 N2 - The vast personal and economic burden of mood disorders is largely caused by their under- and misdiagnosis, which is associated with ineffective treatment and worsening of outcomes. Here, we aimed to develop a diagnostic algorithm, based on an online questionnaire and blood biomarker data, to reduce the misdiagnosis of bipolar disorder (BD) as major depressive disorder (MDD). Individuals with depressive symptoms (Patient Health Questionnaire-9 score ≥5) aged 18-45 years were recruited online. After completing a purpose-built online mental health questionnaire, eligible participants provided dried blood spot samples for biomarker analysis and underwent the World Health Organization World Mental Health Composite International Diagnostic Interview via telephone, to establish their mental health diagnosis. Extreme Gradient Boosting and nested cross-validation were used to train and validate diagnostic models differentiating BD from MDD in participants who self-reported a current MDD diagnosis. Mean test area under the receiver operating characteristic curve (AUROC) for separating participants with BD diagnosed as MDD (N = 126) from those with correct MDD diagnosis (N = 187) was 0.92 (95% CI: 0.86-0.97). Core predictors included elevated mood, grandiosity, talkativeness, recklessness and risky behaviour. Additional validation in participants with no previous mood disorder diagnosis showed AUROCs of 0.89 (0.86-0.91) and 0.90 (0.87-0.91) for separating newly diagnosed BD (N = 98) from MDD (N = 112) and subclinical low mood (N = 120), respectively. Validation in participants with a previous diagnosis of BD (N = 45) demonstrated sensitivity of 0.86 (0.57-0.96). The diagnostic algorithm accurately identified patients with BD in various clinical scenarios, and could help expedite accurate clinical diagnosis and treatment of BD.

Language: en

LA - en SN - 2158-3188 UR - http://dx.doi.org/10.1038/s41398-020-01181-x ID - ref1 ER -