预测诊断转换从严重抑郁症到双相情感障碍:来自哥伦比亚的基于电子健康记录的研究
Susan K Service1, Juan De La Hoz1, Ana M Diaz-Zuluaga1
1Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA.
medRxiv : the preprint server for health sciences
|October 24, 2023
概括
预测双极性障碍 (BD) 从重大抑郁障碍 (MDD) 转化至关重要. 电子病历数据分析确定了关键风险因素,如初始发作的严重程度和自杀念头,使得早期BD诊断和改善患者的治疗结果.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 医疗信息学 医疗信息学
- 临床流行病学临床流行病学
背景情况:
- 双极性障碍 (BD) 是一种慢性精神健康状况,通常最初表现为严重抑郁症 (MDD),导致诊断延迟.
- 早期识别患有MDD的个体,他们面临转化为BD的高风险,对于及时干预和改善预后至关重要.
研究的目的:
- 从电子健康记录 (EHR) 中识别预测重大抑郁症 (MDD) 转化为双极性障碍 (BD) 的临床和人口特征.
- 探索自然语言处理 (NLP) 在临床笔记上的实用性,以发现 BD转换的新风险因素.
主要方法:
- 从15年来对13,607名被诊断患有MDD的患者的EHR数据进行了回顾性分析.
- 多变量考克斯回归建模,以确定BD转换的预测特征.
- 应用NLP技术从非结构化的临床笔记中提取临床特征.
主要成果:
- 关于BD转换的关键预测因素包括初始MDD发作严重程度,精神病,住院,家族病史和女性性别.
- NLP将自杀念头和自杀企图确定为BD转换的新风险因素.
- 鉴定出的风险因素预测了BD在五年内转换,回忆率为72%,准确度为38%.
结论:
- 包括NLP在内的EHR数据分析是预测MDD的BD转换的有效和强大的工具.
- 这项研究证实了已知的风险因素,并确定了新的风险因素,支持早期诊断和针对双极性障碍的有针对性的干预措施.
相关概念视频
01:30Bipolar Disorder
68
Bipolar disorder is a chronic mental health condition marked by significant mood fluctuations, including episodes of mania and depression. Elevated energy levels, heightened mood or irritability, impulsive behavior, reduced sleep needs, rapid speech, racing thoughts, inflated self-esteem, and distractibility characterize mania. Individuals with bipolar disorder often alternate between depressive and manic states, with periods of emotional stability lasting an average of six months to a year.
68
01:27Diagnostic and Statistical Manual of Mental Disorders (DSM)
59
The Diagnostic and Statistical Manual of Mental Disorders (DSM) serves as the primary classification system for mental health disorders, providing standardized diagnostic criteria for clinicians and researchers. First published by the American Psychiatric Association (APA) in 1952, the DSM has undergone several revisions to reflect evolving psychiatric understanding. The fifth edition, DSM-5, released in 2013, introduced key updates that expanded diagnostic categories and modified diagnostic...
59
01:24Mania and Antimanic Drugs: Overview
203
Mania, a psychological condition characterized by elevated mood, increased energy, and reduced sleep need, is part of the bipolar disorder cycle. The exact cause of mania isn't entirely known, but it is thought to be a combination of genetic, environmental, and neurological factors. Bipolar disorder involves alternating manic and depressive episodes. Mood stabilizers like lithium, antipsychotics, and anticonvulsants help manage these episodes. Lithium carbonate is particularly effective as...
203
01:27Depressive Disorders: MDD and Dysthymia
138
Depressive disorders are a group of mental health conditions characterized by pervasive feelings of sadness, diminished pleasure in life, and a significant impact on daily functioning. These conditions are most prevalent in individuals during their 30s and affect women at twice the rate of men. Contrary to popular belief, younger individuals are generally more susceptible to these disorders than older adults. Two key types of depressive disorders include Major Depressive Disorder (MDD) and...
138
01:27Depressive Disorders: Etiology
104
Depressive disorders result from a complex interplay of biological, psychological, and sociocultural factors, each contributing uniquely to the development and persistence of the condition. Understanding these factors provides critical insight into the multifaceted nature of depression.
Biological Factors in Depression
Biological predispositions significantly influence the risk of developing depressive disorders. Genetic studies highlight the role of variations in the serotonin transporter...
Biological Factors in Depression
Biological predispositions significantly influence the risk of developing depressive disorders. Genetic studies highlight the role of variations in the serotonin transporter...
104
01:18Depression: Overview
256
Depression is a prevalent mental illness marked by persistent sadness and lack of interest in previously enjoyable activities. It can take several forms, including major depression, persistent depressive disorder, and bipolar I and II disorders. Symptoms range from emotional changes like chronic worry to physical changes like sleep disturbances and suicidal thoughts. From a neurobiological perspective, depression is believed to be triggered by abnormalities in the brain's prefrontal cortex,...
256