Development of a Model with a Panel of Biochemical Parameters to Identify Major Depressive Disorder
Keywords:
Biochemical Parameters, MDD identification, Model development
Abstract
Background: There is no available biomarker which can detect cases of Major Depressive Disorder (MDD). So a number of cases remain undetected particularly in those set ups where trained physicians are not available. This case control study was carried out with an aim to find out a panel of parameters in cases of MDD. It was also aimed to find out how successfully people can be classified into MDD and normal groups using this model Methods: A total number of 150 cases suffering from MDD were included in this study with an equal number of age and gender matched controls. 10 selective biochemical parameters, chosen from review of literature and corroborating pathogenesis of MDD were estimated in blood of all subjects. The parameters, namely, Cortisol, TSH, Prolactin, hsCRP, Ferritin, Cholesterol, Triglyceride, Calcium and Magnesium were estimated by using commercially available kits. Oxidative Stress Index (OSI) was standardized manually. The predictive model was developed using Multiple Logistic Regression. Then the ROC curve analysis of predictive model was done using the software R. Result: Cholesterol, Triglyceride and Calcium were not considered as they were not found to be significantly altered in MDD. Ferritin was not considered as its level vary according to gender and could not be used as universal parameter. A combined estimation of TSH, Prolactin, hsCRP and Magnesium can identify cases with MDD with 86% sensitivity and 90% specificity. Addition of OSI increases the sensitivity to 93%. Conclusion: The model needs validation by further study.References
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2. Strawbridge R, Young AH, Cleare AJ. Biomarkers for depression: recent insights, current challenges and future prospects. Neuropsychiatr Dis Treat 2017; 13: 1245.
3. Lakhan SE, Vieira K, Hamlat E. Biomarkers in psychiatry: drawbacks and potential for misuse. Int Arch Med 2010; 3:1.
4. Carroll BJ, Curtis GC, Mendels J. Neuroendocrine regulation in depression: Discrimination of depressed from nondepressed patients. Arch Gen Psychiatry 2010, 33: 1051.
5. Dowlati Y, Herrmann N, Swardfager W, Liu H, Sham L, Reim EK & Lanctot KL. A meta-analysis of cytokines in major depression. Biological Psychiatry 2010; 67(5): 446.
6. Carroll D, Ring C, Suter M, Willemsen G. The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: a double-blind placebo-controlled trial. Psychopharmacology (Berl) 2000; 150:220.
7. Sapolsky RM. The possibility of neuro toxicity in the hippocampus in major depression: a primer on neuron death. Biol Psychiatry 2000; 48:755.
8. Primack BA. The WHO 5 Well Being Index performed the best in screening for depression in primary care. Evid Based Med 2003; 8: 155.
9. Bech P, Rasmussen NA, Olsen R, Noerholm V& Abildgaard W. The sensitivity and specificity of the Major Depression Inventory, using the Present State Examination as the index of diagnostic validity. J Affect Dis 2001; 66:159.
10. Goldberg D. Identifying psychiatric illnesses among general medical patients. British Medical Journal 198; 291: 161.
11. Burtis CA, Ashwood ER, editors, Tietz Fundamentals of Clinical Chemistry, WB Saunders, 5th ed. Philadelphia: 2001; 862.
12. Allain CC, Poon LS, Chan CSG, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol. Clin Chem 1974; 20 (4):470.
13. Bucolo G& David H. Quantitative determination of serum Triglycerides by the use of enzymes. Clin Chem 1973; 19: 476.
14. Stern J, Lewis WHP. The colorimetric estimation of calcium in serum with O cresophthalein complexone. Clin Chim Acta 1973; 2: 576.
15. Regulatio Liedtke RJ, Croon G. Automated calmagite measurement of magnesium in serum. Clin Chem 1984; 30:1801.
16. Gupta S, Kunti S, Mondal R, Basu P, Chowdhury K M, Gayen R. Determination of reference limit and evaluation of precision to measure Total Antioxidant Capacity (TAC) by Ferric Reducing Antioxidant Power (FRAP) method. Indian Journal of Basic and Applied Medical Research 2014; 3 (4):308.
17. Dinan TG. Glucocorticoids and the genesis of depressive illness. A psychobiological model. British Journal of Psychiatry 1994; 164:365.
18. Cowen PJ. Cortisol, serotonin and depression: all stressed out? The British Journal of Psychiatry 2002; 180 (2): 99.
19. Gold MS, Pottash AL & Extein I. Hypothyroidism and depression. Evidence from complete thyroid function evaluation. JAMA 2002; 245(19):1919.
20. Horrobin DF. Prolactin and mental illness. Br J Psychiatry 1974; 124: 456.
21. George A, Boyd AE, Seymour R, Don L. Prolactin levels in Mild Depression. Psychosomatic Medicine 1977; 39 (3): 193.
22. Magdaléna Vaváková, Zde^ka uraIková ,Jana Trebatická. Markers of Oxidative Stress and Neuroprogression in Depression Disorder. Oxidative Medicine and Cellular Longevity 2015: 1.
23. Wichers M & Maes M. The psychoneuroimmunopathophysiology of cytokine induced depression in humans. Int J Neuropsychopharmacol 2002; 5 (4): 375.
24. Raison CL, Capuron L, Miller AH. Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends Immunol 2006; 27(1): 24.
25. Marie Kim Wium-Andersen, David Dynnes Ørsted, Sune Fallgaard Nielsen, MScEE & Børge Grønne Nordestgaard. Elevated C - reactive protein Levels, Psychological Distress, and Depression in 73, 131 Individuals. JAMA Psychiatry 2013;70(2): 176.
26. Beard JD, Connor JR, Jones BC. Iron in the brain. Nutr Rev 1993; 51:157.
27. Zieba A, Kata R, Dudek D, Schlegel-Zawadzka M, Nowak G. Serum trace elements in animal models and human depression: Part III. Magnesium. Relationship with copper. Hum Psychopharm Clin 2000; 15: 631–5.
28. Kirov GK, Tsachev KN. Magnesium, schizophrenia and manic depressive disease. Neuropsychobiology, 23:79–81.
29. Black CN, Bot M, Scheffer PG, Cuijpers P, Penninx BW. Is depression associated with increased oxidative stress? A systematic review and meta-analysis. Psychoneuroendocrinology 2015; 51: 164.
Published
2018-06-08
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