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Discrimination between healthy participants and people with panic disorder based on polygenic scores for psychiatric disorders and for intermediate phenotypes using machine learning 利用机器学习,根据精神疾病和中间表型的多基因评分,区分健康参与者和恐慌症患者
Pub Date : 2024-04-06 DOI: 10.1177/00048674241242936
Kazutaka Ohi, Yuta Tanaka, Takeshi Otowa, Mihoko Shimada, Hisanobu Kaiya, Fumichika Nishimura, Tsukasa Sasaki, Hisashi Tanii, Toshiki Shioiri, Takeshi Hara
Objective:Panic disorder is a modestly heritable condition. Currently, diagnosis is based only on clinical symptoms; identifying objective biomarkers and a more reliable diagnostic procedure is desirable. We investigated whether people with panic disorder can be reliably diagnosed utilizing combinations of multiple polygenic scores for psychiatric disorders and their intermediate phenotypes, compared with single polygenic score approaches, by applying specific machine learning techniques.Methods:Polygenic scores for 48 psychiatric disorders and intermediate phenotypes based on large-scale genome-wide association studies ( n = 7556–1,131,881) were calculated for people with panic disorder ( n = 718) and healthy controls ( n = 1717). Discrimination between people with panic disorder and healthy controls was based on the 48 polygenic scores using five methods for classification: logistic regression, neural networks, quadratic discriminant analysis, random forests and a support vector machine. Differences in discrimination accuracy (area under the curve) due to an increased number of polygenic score combinations and differences in the accuracy across five classifiers were investigated.Results:All five classifiers performed relatively well for distinguishing people with panic disorder from healthy controls by increasing the number of polygenic scores. Of the 48 polygenic scores, the polygenic score for anxiety UK Biobank was the most useful for discrimination by the classifiers. In combinations of two or three polygenic scores, the polygenic score for anxiety UK Biobank was included as one of polygenic scores in all classifiers. When all 48 polygenic scores were used in combination, the greatest areas under the curve significantly differed among the five classifiers. Support vector machine and logistic regression had higher accuracy than quadratic discriminant analysis and random forests. For each classifier, the greatest area under the curve was 0.600 ± 0.030 for logistic regression (polygenic score combinations N = 14), 0.591 ± 0.039 for neural networks ( N = 9), 0.603 ± 0.033 for quadratic discriminant analysis ( N = 10), 0.572 ± 0.039 for random forests ( N = 25) and 0.617 ± 0.041 for support vector machine ( N = 11). The greatest areas under the curve at the best polygenic score combination significantly differed among the five classifiers. Random forests had the lowest accuracy among classifiers. Support vector machine had higher accuracy than neural networks.Conclusions:These findings suggest that increasing the number of polygenic score combinations up to approximately 10 effectively improved the discrimination accuracy and that support vector machine exhibited greater accuracy among classifiers. However, the discrimination accuracy for panic disorder, when based solely on polygenic score combinations, was found to be modest.
目的:恐慌症是一种有一定遗传性的疾病。目前,诊断仅以临床症状为依据;我们希望找到客观的生物标志物和更可靠的诊断程序。方法:根据大规模全基因组关联研究(n = 7556-1,131,881 例)计算出惊恐障碍患者(n = 718 例)和健康对照组(n = 1717 例)的 48 种精神疾病和中间表型的多基因评分。恐慌症患者和健康对照组之间的鉴别基于 48 个多基因得分,采用了五种分类方法:逻辑回归、神经网络、二次判别分析、随机森林和支持向量机。结果:通过增加多基因得分的数量,所有五种分类器在区分惊恐障碍患者和健康对照者方面的表现都相对较好。在 48 个多基因评分中,英国生物库焦虑症多基因评分对分类器的区分作用最大。在两个或三个多基因得分的组合中,所有分类器都将英国生物库焦虑症多基因得分作为多基因得分之一。当组合使用所有 48 个多基因分数时,五个分类器的最大曲线下面积差异显著。支持向量机和逻辑回归的准确率高于二次判别分析和随机森林。在每个分类器中,逻辑回归(多基因分数组合 N = 14)的最大曲线下面积为 0.600 ± 0.030,神经网络(N = 9)为 0.591 ± 0.039,二次判别分析(N = 10)为 0.603 ± 0.033,随机森林(N = 25)为 0.572 ± 0.039,支持向量机(N = 11)为 0.617 ± 0.041。五种分类器在最佳多基因得分组合的最大曲线下面积上存在显著差异。随机森林分类器的准确率最低。结论:这些研究结果表明,将多基因分数组合的数量增加到大约 10 个,可以有效提高分辨准确率,而且支持向量机在分类器中表现出更高的准确率。然而,如果仅基于多基因分数组合,恐慌症的判别准确率并不高。
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引用次数: 0
Co-occurring psychological distress and alcohol or other drug use among Indigenous Australians: Data from the National Aboriginal and Torres Strait Islander Health Survey 澳大利亚土著居民中同时存在的心理困扰与酒精或其他药物的使用:来自全国土著居民和托雷斯海峡岛民健康调查的数据
Pub Date : 2024-04-06 DOI: 10.1177/00048674241244601
Breanne Hobden, Jamie Bryant, Robert Davis, Todd Heard, Jenn Rumbel, Jamie Newman, Bron Rose, David Lambkin, Rob Sanson-Fisher, Megan Freund
Objectives:To determine the prevalence and demographic, social and health characteristics associated with co-occurring psychological distress symptoms, risky alcohol and/or substance use among a national sample of Aboriginal and Torres Strait Islander people aged 15 years or older.Methods:This study uses secondary cross-sectional data from the 2018-19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS). Data were collected via face-to-face interviews with those living in private dwellings across Australia. Participants were Aboriginal and Torres Strait Islander people ( n = 10,579) aged 15 years or older. Data pertaining to psychological distress, alcohol and substance use were obtained and weighted to represent the total population of Aboriginal and Torres Strait Islander people in Australia.Results:A total of 20.3% participants were found to have co-occurring psychological distress, risky alcohol use and/or substance use, and 4.0% reported co-occurrence of all three conditions. Female participants in a registered marriage and fully engaged in study or employment had lower rates of co-occurring conditions. Poorer self-rated health, one or more chronic conditions and increased experiences of unfair treatment and physical harm in the past 12 months were associated with increased rates of co-occurring conditions.Conclusion:A range of potential risk and protective factors were identified for co-occurring psychological distress, risky alcohol and/or substance use among Aboriginal and Torres Strait Islander people. This information is critical for planning effective holistic strategies to decrease the burden of suffering imposed upon the individual, family and community members impacted by co-occurring conditions.
目标:在全国 15 岁或以上的原住民和托雷斯海峡岛民样本中,确定与并发心理困扰症状、危险酒精和/或药物使用相关的患病率及人口、社会和健康特征。方法:本研究使用 2018-19 年全国原住民和托雷斯海峡岛民健康调查(NATSIHS)的二级横截面数据。数据是通过与澳大利亚各地私人住宅中的居民进行面对面访谈收集的。参与者为年龄在15岁或15岁以上的原住民和托雷斯海峡岛民(n=10579)。结果显示:20.3%的参与者同时存在心理困扰、酗酒和/或使用药物的风险,4.0%的参与者报告同时存在这三种情况。已登记结婚并全身心投入学习或就业的女性参与者中,并发症发生率较低。自评健康状况较差、患有一种或多种慢性疾病以及在过去 12 个月中遭受过更多不公平待遇和身体伤害的经历与并发症发生率增加有关。这些信息对于规划有效的整体战略以减轻受并发症影响的个人、家庭和社区成员的痛苦负担至关重要。
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引用次数: 0
Physical multimorbidity and mental illness: A global challenge 身体多病和精神疾病:全球挑战
Pub Date : 2024-03-04 DOI: 10.1177/00048674241235587
Sean Halstead, Norman Sartorius, Susanna Every-Palmer, Najma Siddiqi, Giovanni de Girolamo, Dan Siskind, Nicola Warren
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引用次数: 0
RANZCP Abstracts RANZCP抽象
Pub Date : 2023-05-01 DOI: 10.1177/00048674231169682
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引用次数: 3
Book Review of “Psychopathology of Rare and Unusual Syndromes” by Femi Oyebode Femi Oyebode的《罕见和不寻常综合症的精神病理学》书评
Pub Date : 2023-02-01 DOI: 10.1177/00048674221150360
Owen P. O’Sullivan
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引用次数: 0
Mania 躁狂
Pub Date : 2022-10-27 DOI: 10.1007/978-3-540-68706-1_518
Paul B. Badcock
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引用次数: 0
Seeking mental health support as a psychiatrist 寻求精神科医生的精神健康支持
Pub Date : 2022-06-11 DOI: 10.1177/00048674221104403
I. Berger
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引用次数: 2
The AREDOC project and its implications for the definition and measurement of the bipolar disorders: A summary report AREDOC项目及其对双相情感障碍的定义和测量的意义:一份总结报告
Pub Date : 2022-06-10 DOI: 10.1177/00048674221103478
G. Parker, Michael J. Spoelma, G. Tavella
Objectives: Judging that the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria for defining mania/hypomania (and thus bipolar I/II disorders, respectively) would benefit from review, we formed an expert taskforce to derive modified criteria for consideration. The aim of this paper is to summarise the component stages and detail the final recommended criteria. Methods: We first sought taskforce members’ views on the Diagnostic and Statistical Manual of Mental Disorders criteria and how they might be modified. Next, members recruited patients with a bipolar I or II disorder, and who were asked to judge new definitional options and complete a symptom checklist to determine the most differentiating items. The latter task was also completed by a small comparison group of unipolar depressed patients to determine the mood state items that best differentiate unipolar from bipolar subjects. Subsequent reports overviewed analyses arguing for bipolar I and II as being categorically distinct and generated empirically derived diagnostic criteria. Results: Alternatives to all the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria were generated. Modifications included recognising that impairment is not a necessary criterion, removing hospitalisation as automatically assigning bipolar I status, adding an irritable/angry symptom construct to the symptom list, deleting a mandatory duration period for manic/hypomanic episodes, and requiring a greater number of affirmed symptoms for a bipolar diagnosis to manage the risk of overdiagnosis. Granular symptom criteria were identified by analyses and constructed to assist clinician assessment. A potential bipolar screening measure was developed with analyses showing that it could clearly distinguish bipolar versus unipolar status, whether symptom items were assigned as having equal status or weighted by their quantified diagnostic contribution. Conclusion: While requiring further validation, we suggest that the revised criteria overcome several current Diagnostic and Statistical Manual of Mental Disorders (5th ed.) limitations to defining and differentiating the two bipolar sub-types, while still respecting and preserving the Diagnostic and Statistical Manual of Mental Disorders template. It will be necessary to determine whether the bipolar screening measure has superiority to currently accepted measures.
目的:判断《精神障碍诊断与统计手册》(第5版)定义躁狂症/轻躁症(以及双相I/II障碍)的标准将从审查中受益,我们成立了一个专家工作组来得出修改后的标准以供考虑。本文的目的是总结组成阶段和详细的最终推荐标准。方法:我们首先征求工作组成员对《精神障碍诊断与统计手册》标准的看法,以及如何修改这些标准。接下来,成员们招募患有双相I或II型障碍的患者,并要求他们判断新的定义选项,并完成症状清单,以确定最具区别的项目。后一项任务也由一小组单极抑郁症患者完成,以确定最能区分单极和双相患者的情绪状态项目。随后的报告概述了分析,认为双相I和II是截然不同的,并产生了经验推导的诊断标准。结果:产生了所有精神障碍诊断与统计手册(第5版)标准的替代方案。修改包括认识到损害不是必要的标准,取消住院作为自动分配双相I状态,在症状列表中添加易怒/愤怒症状结构,删除躁狂/轻躁发作的强制性持续时间,并要求更多的双相诊断确认症状来管理过度诊断的风险。通过分析确定颗粒症状标准,并构建以协助临床医生评估。一种潜在的双相筛查方法被开发出来,分析表明它可以清楚地区分双相和单相状态,无论症状项目是否被分配为具有相同的地位或通过其量化的诊断贡献来加权。结论:虽然需要进一步验证,但我们建议修订后的标准克服了当前精神障碍诊断和统计手册(第5版)在定义和区分两种双相亚型方面的几个限制,同时仍然尊重和保留精神障碍诊断和统计手册的模板。有必要确定双相筛查措施是否优于目前接受的措施。
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引用次数: 2
The broader benefits of DBS for refractory OCD DBS治疗难治性强迫症的更广泛益处
Pub Date : 2022-06-10 DOI: 10.1177/00048674221103491
G. Malhi, Erica Bell, Cornélia Kaufmann, V. Brakoulias
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引用次数: 1
Advancing translational neuroscience research for eating disorders 推进饮食失调的转化神经科学研究
Pub Date : 2022-06-08 DOI: 10.1177/00048674221106678
C. Foldi, M. James, RobynM . Brown, M. Piya, T. Steward
Australian & New Zealand Journal of Psychiatry, 56(7) Eating disorders are among the most complex psychiatric disorders encountered in clinical practice, with anorexia nervosa (AN), for example, having the highest mortality rate of any psychiatric illness. The aetiology of eating disorders remains elusive and the development of targeted pharmacological interventions for eating disorders has stalled. Moreover, a 2017 study found that government funding for eating disorder research in Australia equates to approximately AUD$1.10 per affected individual, in noticeable contrast to research funding for schizophrenia standing at AUD$67.36 per affected individual (Murray et al., 2017). At the 2022 Meeting of the Australia and New Zealand Academy of Eating Disorders (ANZAED), we held a Plenary session entitled ‘Translating eating disorders neuroscience research: Lessons from bench-to-bedside treatments’ to highlight potential avenues for the development of novel eating disorder treatments. This article presents a summary of the topics covered therewithin.
澳大利亚和新西兰精神病学杂志,56(7)饮食失调是临床实践中遇到的最复杂的精神障碍之一,例如神经性厌食症(AN)是所有精神疾病中死亡率最高的。饮食失调的病因仍然难以捉摸,针对饮食失调的药物干预的发展已经停滞。此外,2017年的一项研究发现,澳大利亚政府为饮食失调研究提供的资金相当于每个受影响个体约1.10澳元,与精神分裂症的研究资金形成鲜明对比,每个受影响个体的研究资金为67.36澳元(Murray et al., 2017)。在澳大利亚和新西兰饮食失调学会(ANZAED) 2022年会议上,我们举行了题为“转化饮食失调神经科学研究:从实验到临床治疗的经验教训”的全体会议,以强调发展新型饮食失调治疗的潜在途径。本文概述了其中涉及的主题。
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引用次数: 2
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Australian & New Zealand Journal of Psychiatry
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