Research and Diagnostic Algorithmic Rules (RADAR) for mood disorders, recurrence of illness, suicidal behaviours, and the patient’s lifetime trajectory

Abstract

The top-down DSM/ICD categories of mood disorders are inaccurate, and their dogmatic nature precludes both deductive (as indisputable) and inductive (as top-down) remodeling of case definitions. In trials, psychiatric rating scale scores employed as outcome variables are invalid and rely on folk psychology-like narratives. Using machine learning techniques we developed a new precision nomothetic model of mood disorders with a recurrence of illness (ROI) index, a new endophenotype class, namely Major Dysmood Disorder (MDMD), characterized by increased ROI, a more severe phenome, and more disabilities Nonetheless, our previous studies did not compute Research and Diagnostic Algorithmic Rules (RADAR) to diagnose MDMD and score ROI, lifetime (LT), and current suicidal behaviors, as well as the phenome of mood disorders. Here we provide rules to compute bottom-up RADAR scores for MDMD, ROI, lifetime (LT) and current suicidal SI and SA, the phenome of mood disorders, and the lifetime trajectory of mood disorder patients from a family history of mood disorders and substance abuse to adverse childhood experiences, ROI, and the phenome. We also demonstrate how to plot the 12 major scores in a single RADAR graph, which displays all features in a two-dimensional plot. These graphs allow the characteristics of a patient to be displayed as an idiomatic fingerprint, allowing one to estimate the key traits and severity of the illness at a glance. Consequently, biomarker research into mood disorders should use our RADAR scores to examine pan-omics data, which should be used to enlarge our precision models and RADAR graph.

Adverse childhood trauma and reoccurrence of illness impact the gut microbiome, which affects suicidal behaviors and the phenome of major depression: towards enterotypic-phenotypes

“…Nevertheless, in our previous study, MDD was additionally associated with some other taxa. However, the phenome of depression assessed in our investigations (Maes, 2022; Maes et al, 2022a; Maes and Stoyanov, 2022) is a significantly more accurate measure of depression than the binary MDD diagnosis. The phenome evaluates the severity of the combination of several depressive features, and as a quantitative score, and provides more information than MDD, which is an incorrect model (see Introduction).…”

“…The test measures the severity and intensity of suicidal ideation, attempts, lethality, and self-harm without suicidal intent. We calculated the PCs extracted from lifetime (LT) and current (current) suicidal ideation (SI) and attempts (SA) and suicidal behaviors (SB, ideation and attempts combined) as explained previously (Maes et al, 2022a). As such, we derived scores of lifetime (LT)_SI, LT_SA, LT_SB, current_SI, current_SA, current_SB, and overall SB (a PC extracted from LT and current SI and SA) (Maes et al, 2022a; Maes, 2022).…”

“…We calculated the PCs extracted from lifetime (LT) and current (current) suicidal ideation (SI) and attempts (SA) and suicidal behaviors (SB, ideation and attempts combined) as explained previously (Maes et al, 2022a). As such, we derived scores of lifetime (LT)_SI, LT_SA, LT_SB, current_SI, current_SA, current_SB, and overall SB (a PC extracted from LT and current SI and SA) (Maes et al, 2022a; Maes, 2022). The research psychologist also examined the Stroop color and word test (SCWT), namely parts 1 (a neutral trial that measures reaction times), part 2 (congruent trial) and part 3 (incongruent trial) (Stroop, 1935).…”

“…As a result, it was proposed that increased LPS translocation may be one of the causes of immune activation and oxidative stress in MDD by activating the Toll-Like Receptor-4 (TLR4) complex and, consequently, nuclear factor-κB (NF-κB) (Lucas and Maes, 2013). There is now evidence that MDD is a disorder characterized by activated immune-inflammatory and nitro-oxidative pathways and that these pathways to a large extent determine the MDD phenome and accompanying suicidal behaviors (Maes et al, 1990; 1997; Maes et al, 2021; 2022a; 2002b; Maes, 2022; Vasupanrajit et al, 2021; 2022). Activated immune and oxidative stress pathways may cause epithelial tight junction abnormalities that increase intestinal permeability and bacterial translocation (Maes et al, 2008; 2012).…”

“…Second, the microbiome is strongly influenced by diet; consequently, region-or culture-specific alterations in the microbiome may define different microbiome profiles of MDD in different countries or cultures (Singh et al, 2017). Last but not least, the diagnosis of MDD is practically useless for biomarker research because MDD is an incorrect outcome variable that can hardly be used in statistical analysis (Maes, 2022;Maes et al, 2022a;Maes and Stoyanov, 2022). Indeed, MDD is a heterogeneous group that includes severe depression, melancholia phenotypes, mild depression, and possibly even normal human emotional responses such as grief, sadness, and despondency (Maes et al, 2022;Maes and Stoyanov, 2022).…”