Lalousis, Paris Alexandros ORCID: 0000-0001-9642-3080, Wood, Stephen J., Schmaal, Lianne, Chisholm, Katharine ORCID: 0000-0002-0575-0789, Griffiths, Sian Lowri, Reniers, Renate L. E. P., Bertolino, Alessandro, Borgwardt, Stefan, Brambilla, Paolo, Kambeitz, Joseph ORCID: 0000-0002-8988-3959, Lencer, Rebekka, Pantelis, Christos ORCID: 0000-0002-9565-0238, Ruhrmann, Stephan, Salokangas, Raimo K. R., Schultze-Lutter, Frauke, Bonivento, Carolina, Dwyer, Dominic, Ferro, Adele, Haidl, Theresa, Rosen, Marlene, Schmidt, Andre ORCID: 0000-0001-6055-8397, Meisenzahl, Eva, Koutsouleris, Nikolaos and Upthegrove, Rachel ORCID: 0000-0001-8204-5103 (2021). Heterogeneity and Classification of Recent Onset Psychosis and Depression: A Multimodal Machine Learning Approach. Schizophr. Bull., 47 (4). S. 1130 - 1141. OXFORD: OXFORD UNIV PRESS. ISSN 1745-1701

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Abstract

Diagnostic heterogeneity within and across psychotic and affective disorders challenges accurate treatment selection, particularly in the early stages. Delineation of shared and distinct illness features at the phenotypic and brain levels may inform the development of more precise differential diagnostic tools. We aimed to identify prototypes of depression and psychosis to investigate their heterogeneity, with common, comorbid transdiagnostic symptoms. Analyzing clinical/neurocognitive and grey matter volume (GMV) data from the PRONIA database, we generated prototypic models of recent-onset depression (ROD) vs. recent-onset psychosis (ROP) by training support-vector machines to separate patients with ROD from patients with ROP, who were selected for absent comorbid features (pure groups). Then, models were applied to patients with comorbidity, ie, ROP with depressive symptoms (ROP+D) and ROD participants with sub-threshold psychosis-like features (ROD+P), to measure their positions within the affective-psychotic continuum. All models were independently validated in a replication sample. Comorbid patients were positioned between pure groups, with ROP+D patients being more frequently classified as ROD compared to pure ROP patients (clinical/neurocognitive model: chi 2 = 14.874; P < .001; GMV model: chi 2 = 4.933; P = .026). ROD+P patient classification did not differ from ROD (clinical/neurocognitive model: chi 2 = 1.956; P = 0.162; GMV model: chi 2 = 0.005; P = .943). Clinical/neurocognitive and neuroanatomical models demonstrated separability of prototypic depression from psychosis. The shift of comorbid patients toward the depression prototype, observed at the clinical and biological levels, suggests that psychosis with affective comorbidity aligns more strongly to depressive rather than psychotic disease processes. Future studies should assess how these quantitative measures of comorbidity predict outcomes and individual responses to stratified therapeutic interventions.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Lalousis, Paris AlexandrosUNSPECIFIEDorcid.org/0000-0001-9642-3080UNSPECIFIED
Wood, Stephen J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmaal, LianneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chisholm, KatharineUNSPECIFIEDorcid.org/0000-0002-0575-0789UNSPECIFIED
Griffiths, Sian LowriUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reniers, Renate L. E. P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bertolino, AlessandroUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Borgwardt, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brambilla, PaoloUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kambeitz, JosephUNSPECIFIEDorcid.org/0000-0002-8988-3959UNSPECIFIED
Lencer, RebekkaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pantelis, ChristosUNSPECIFIEDorcid.org/0000-0002-9565-0238UNSPECIFIED
Ruhrmann, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Salokangas, Raimo K. R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schultze-Lutter, FraukeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bonivento, CarolinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dwyer, DominicUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ferro, AdeleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haidl, TheresaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosen, MarleneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmidt, AndreUNSPECIFIEDorcid.org/0000-0001-6055-8397UNSPECIFIED
Meisenzahl, EvaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koutsouleris, NikolaosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Upthegrove, RachelUNSPECIFIEDorcid.org/0000-0001-8204-5103UNSPECIFIED
URN: urn:nbn:de:hbz:38-604697
DOI: 10.1093/schbul/sbaa185
Journal or Publication Title: Schizophr. Bull.
Volume: 47
Number: 4
Page Range: S. 1130 - 1141
Date: 2021
Publisher: OXFORD UNIV PRESS
Place of Publication: OXFORD
ISSN: 1745-1701
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
DETECTING NEUROIMAGING BIOMARKERS; GENERALIZABILITY THEORY; SCHIZOPHRENIA; DISORDERS; OPPORTUNITIES; METAANALYSIS; ANHEDONIA; FEATURES; BURDEN; COSTMultiple languages
PsychiatryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60469

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