Novel screening tool for psychiatric samples with major depressive disorder: a two-centre study.

Area of Science:

• Psychiatry and Mental Health
• Diagnostic Tool Development
• Clinical Epidemiology

Background:

• Major depressive disorder (MDD) is a major global health concern.
• Current screening tools like the Patient Health Questionnaire-9 (PHQ-9) have limited validation in psychiatric populations and potential diagnostic inaccuracies due to variable cut-off values.
• There is a need for improved MDD screening precision in psychiatric samples.

Purpose of the Study:

• To develop and validate a highly accurate nomogram for MDD screening specifically within psychiatric samples.
• To enhance the precision of MDD diagnosis compared to existing methods.

Main Methods:

• Consecutive recruitment of participants from psychiatric outpatient clinics into training (n=519) and validation (n=225) cohorts.
• Utilized Least Absolute Shrinkage and Selection Operator (LASSO) regression for feature selection and multivariable logistic regression to construct a weighted nomogram.
• Rigorous evaluation of the nomogram's discriminative ability, calibration, and clinical utility through internal and external validation.

Main Results:

• The developed nomogram demonstrated superior performance over the PHQ-9 in both internal and external validation cohorts.
• The nomogram achieved higher Area Under the Curve (AUC) values (internal: 0.932 vs 0.874; external: 0.935 vs 0.888, p<0.001 for both).
• The nomogram also showed better calibration and clinical utility, suggesting a potential reduction in false-positive and false-negative screening rates.

Conclusions:

• A novel nomogram was successfully developed for MDD screening in psychiatric samples.
• This tool integrates weighted relevant factors to significantly improve diagnostic accuracy.
• The nomogram represents a promising advancement for precise MDD identification in clinical psychiatric settings.