A machine learning algorithm to differentiate bipolar disorder from major depressive disorder using an online mental health questionnaire and blood biomarker data

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2021-01-01

Author

Tomasik, Jakub
Han, Sung Yeon Sarah
Barton-Owen, Giles
Mirea, Dan-Mircea
Martin-Key, Nayra A.
Rustogi, Nitin
Lago, Santiago G.
Olmert, Tony
Cooper, Jason D.
Özcan Kabasakal, Süreyya
Eljasz, Pawel
Thomas, Gregoire
Tuytten, Robin
Metcalfe, Tim
Schei, Thea S.
Farrag, Lynn P.
Friend, Lauren V.
Bell, Emily
Cowell, Dan
Bahn, Sabine

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The vast personal and economic burden of mood disorders is largely caused by their under- and misdiagnosis, which is associated with ineffective treatment and worsening of outcomes. Here, we aimed to develop a diagnostic algorithm, based on an online questionnaire and blood biomarker data, to reduce the misdiagnosis of bipolar disorder (BD) as major depressive disorder (MDD). Individuals with depressive symptoms (Patient Health Questionnaire-9 score >= 5) aged 18-45 years were recruited online. After completing a purpose-built online mental health questionnaire, eligible participants provided dried blood spot samples for biomarker analysis and underwent the World Health Organization World Mental Health Composite International Diagnostic Interview via telephone, to establish their mental health diagnosis. Extreme Gradient Boosting and nested cross-validation were used to train and validate diagnostic models differentiating BD from MDD in participants who self-reported a current MDD diagnosis. Mean test area under the receiver operating characteristic curve (AUROC) for separating participants with BD diagnosed as MDD (N = 126) from those with correct MDD diagnosis (N = 187) was 0.92 (95% CI: 0.86-0.97). Core predictors included elevated mood, grandiosity, talkativeness, recklessness and risky behaviour. Additional validation in participants with no previous mood disorder diagnosis showed AUROCs of 0.89 (0.86-0.91) and 0.90 (0.87-0.91) for separating newly diagnosed BD (N = 98) from MDD (N = 112) and subclinical low mood (N = 120), respectively. Validation in participants with a previous diagnosis of BD (N = 45) demonstrated sensitivity of 0.86 (0.57-0.96). The diagnostic algorithm accurately identified patients with BD in various clinical scenarios, and could help expedite accurate clinical diagnosis and treatment of BD.

URI

https://hdl.handle.net/11511/88826

Journal

TRANSLATIONAL PSYCHIATRY

DOI

https://doi.org/10.1038/s41398-020-01181-x

Collections

Department of Chemistry, Article

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Citation Formats

J. Tomasik et al., “A machine learning algorithm to differentiate bipolar disorder from major depressive disorder using an online mental health questionnaire and blood biomarker data,” TRANSLATIONAL PSYCHIATRY, pp. 0–0, 2021, Accessed: 00, 2021. [Online]. Available: https://hdl.handle.net/11511/88826.