Etiology and Diagnosis of Major Depression—A Novel Quantitative Approach
Open accessAbstract
Background: Classical psychiatric opinions are relative uncertain and treatment results are not impressive when dealing with major depression. Depression is related to the endocrine system, but despite much effort a good quantitative measure for characterizing depression has not yet emerged. Methods: Based on ACTH and cortisol levels and using clustering analysis and mixture effect modeling we propose a novel and scientifically based quantitative index, denoted the O-index. The O-index combines a weighted and scaled deviation from normal values in both ACTH and cortisol. Results: Using ANOVA we compare the O-index with opinions reach by classical psychiatric diagnostic procedure (sensitivity 83%, specificity 59%, likelihood ratio positive 2.0, and likelihood ratio negative 0.29). The O-index nicely refines the etiology of depression: Combined with clinical data for 29 subjects earlier reported three categories emerge (p = 4.4 × 10-13): hypocortisolemic depressed, non-depressed, and hypercotisolemic depressed. The O-index also reveals why it has been difficult to obtain good markers earlier. It explains that healthy subjects may have an elevated (suppressed) level of cortisol or ACTH, however, the healthy system is able to deal with such elevated (suppressed) levels by compensating through suppressing (stimulating) the other component. In contrast the O-index shows that depressed subjects are incapable of making such compensation to a satisfactory degree. We illustrate how the O-index may be used for diagnostic procedure. Discussion: The methods are discussed and based on the available data material we propose that the O-index may be used to improve the diagnostic procedure and consequently the follow-up treatment.
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The model differentiates between the hypercortisolemic depressed and control groups in agreement with the findings in [39].
“We notice that the model differentiates between the groups in agreement with the findings in [39] where mixture modeling and cluster analysis has been used.”
From Patient specific modeling of the HPA axis related to clinical diagnosis of depression (2017) · cites this paper as [39]
In [39], a mixture density function and cluster analysis showed three clusters statistically related to non-depressed, hypercortisolemic depressed, and hypocortisolemic depressed subjects.
“In [39] a mixture density function and cluster analysis approach are showing that the outcome of three clusters turn out to be statistically related to non-depressed subjects, hypercortisolemic depressed subjects and hypocortisolemic depressed subjects.”
From Patient specific modeling of the HPA axis related to clinical diagnosis of depression (2017) · cites this paper as [39]
Healthy subjects may have elevated or suppressed cortisol or ACTH but compensate by suppressing or stimulating the other component; depressed subjects are incapable of such compensation.
“It is shown that healthy subjects may have an elevated (suppressed) level of cortisol or ACTH, however, the healthy system is able to deal with such elevated (suppressed) levels by compensating through suppressing (stimulating) the other component. Depressed subjects, however, are incapable of making such compensation.”
From Patient specific modeling of the HPA axis related to clinical diagnosis of depression (2017) · cites this paper as [39]
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Patient specific modeling of the HPA axis related to clinical diagnosis of depression
Bangsgaard, E. O., & Ottesen, J. T. (2017) · Mathematical Biosciences · doi:10.1016/j.mbs.2016.10.007 · Cited by 31 · see citing works
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Self-citationA Unified Computational Model for the Human Response to Lipopolysaccharide-Induced Inflammation
Windoloski, K. A., Bangsgaard, E. O., Dobréva, A., Ottesen, J. T., & Olufsen, M. S. (2022) · Mathematics online first collections · doi:10.1007/16618_2022_39 · Cited by 2 · see citing works
Self-citation
- Authors
- Ottesen, J. T.
- Affiliations
- Roskilde University (DK)
- Corresponding author
- Ottesen, Johnny T.
- ORCID
- Ottesen, Johnny T.
- Venue
- Open Journal of Endocrine and Metabolic Diseases
- Publisher
- Scientific Research Publishing, Inc.
- Published
- 2013
- Volume
- 03
- Issue
- 02
- Pages
- 120-127
- ISSN
- 2165-7424 (ISSN-L)
- 2165-7432
- OpenAlex
- W1987557049
- Semantic Scholar
- 463981c48d9eaacd9c2a93aeb790a3b2fbd6a18d
- Cited by
- 3
- References
- 21
- Citations by year
- 2022: 1 · 2016: 1 · 2014: 1
- FWCI
- 0.30
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Open Journal of Endocrine and Metabolic Diseases (publishedVersion, cc-by)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- major depressive disorder, ACTH, cortisol, depression diagnosis, biomarkers, clustering, hypothalamic-pituitary-adrenal axis
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