Exploratory Clinical Trial of a Depression Diagnostic Software That Integrates Stress Biomarkers and Composite Psychometrics
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective This study evaluated the clinical effectiveness of Minds.NAVI, a depression screening kit combining psychometric measures and stress hormone biomarkers, in a prospective clinical trial. The objective was to assess its potential as a depression screening tool and investigate the associations between psychological assessments, salivary hormone staging, and depression severity.Methods Thirty-five participants with major depressive disorder and 12 healthy controls (HCs) were included. The Minds.NAVI software, utilizing the PROtective and Vulnerable factors battEry Test (PROVE) and salivary cortisol/dehydroepiandrosterone (DHEA) analysis, was employed. The PROVE test is a comprehensive self-report questionnaire that assesses depressive symptoms, suicide risk, attachment style, adverse childhood experiences, mentalization capacity, and resilience. In addition, salivary cortisol and DHEA levels were measured to evaluate the functional stage of the hypothalamic–pituitary–adrenal (HPA) axis.Results Minds.NAVI exhibited 100% sensitivity, 91.7% specificity, and 97.9% accuracy in distinguishing depression from HCs within an exploratory small group. Salivary stress hormone phases showed changes with depression stage (p=0.030), and the proportion of patients with “adrenal exhaustion stage” was higher in the moderate/severe depression group (p=0.038). Protective/vulnerable factors differed significantly between controls and depressed groups (p<0.001). Cortisol awakening response inversely correlated with depressive symptom severity (r=-0.31, p=0.034).Conclusion This study suggested possible clinical effectiveness of Minds.NAVI, a depression screening tool that integrates psychometric measures and stress hormone biomarkers. The findings support the potential association between depression, chronic stress, and HPA axis hyporesponsiveness.
Abstract
Objective This study evaluated the clinical effectiveness of Minds.NAVI, a depression screening kit combining psychometric measures and stress hormone biomarkers, in a prospective clinical trial. The objective was to assess its potential as a depression screening tool and investigate the associations between psychological assessments, salivary hormone staging, and depression severity.Methods Thirty-five participants with major depressive disorder and 12 healthy controls (HCs) were included. The Minds.NAVI software, utilizing the PROtective and Vulnerable factors battEry Test (PROVE) and salivary cortisol/dehydroepiandrosterone (DHEA) analysis, was employed. The PROVE test is a comprehensive self-report questionnaire that assesses depressive symptoms, suicide risk, attachment style, adverse childhood experiences, mentalization capacity, and resilience. In addition, salivary cortisol and DHEA levels were measured to evaluate the functional stage of the hypothalamic–pituitary–adrenal (HPA) axis.Results Minds.NAVI exhibited 100% sensitivity, 91.7% specificity, and 97.9% accuracy in distinguishing depression from HCs within an exploratory small group. Salivary stress hormone phases showed changes with depression stage (p=0.030), and the proportion of patients with “adrenal exhaustion stage” was higher in the moderate/severe depression group (p=0.038). Protective/vulnerable factors differed significantly between controls and depressed groups (p<0.001). Cortisol awakening response inversely correlated with depressive symptom severity (r=-0.31, p=0.034).Conclusion This study suggested possible clinical effectiveness of Minds.NAVI, a depression screening tool that integrates psychometric measures and stress hormone biomarkers. The findings support the potential association between depression, chronic stress, and HPA axis hyporesponsiveness.
참고문헌 (47)
- World Health Organization, "Depressive disorder(depression)" (2023), World Health Organization
- Korea Disease Control and Prevention Agency, "Korea health statistics 2020 : Korea national health and nutrition examination survey(KNHANES VIII-2)", Korea Disease Control and Prevention Agency, ~ (2022)
- Fried EI, "What are ‘good’ depression symptoms? Comparing the centrality of DSM and non-DSM symptoms of depression in a network analysis", J Affect Dis ord, 189, pp.314~320 (2016)
- Strawbridge R, "Biomarkers for depression : re cent insights, current challenges and future prospects", Neuropsychiatr Dis Treat, 13, pp.1245~1262 (2017)
- Kennis M, "Prospective biomarkers of major depressive disorder : a systematic review and meta-analysis", Mol Psychiatry, 25, pp.321~338 (2020)
- Eisenlohr-Moul TA, "HPA axis response and psychosocial stress as interac tive predictors of suicidal ideation and behavior in adolescent females : a multilevel diathesis-stress framework", Neuropsychopharmacology, 43, pp.2564~2571 (2018)
- Ahn RS, "Salivary cortisol and DHEA levels in the Korean population : age-related differences, diur nal rhythm, and correlations with serum levels", Yonsei Med J, 48, pp.379~388 (2007)
- Pariante CM, "The HPA axis in major depression : classi cal theories and new developments", Trends Neurosci, 31, pp.464~468 (2008)
- Modell S, "Corticosteroid receptor function is decreased in depressed patients", Neuroendocrinology, 65, pp.216~222 (1997)
- Bhagwagar Z, "Increased salivary cortisol after wak ing in depression", Psychopharmacology(Berl), 182, pp.54~57 (2005)
- Pariante CM, "The glucocorticoid receptor : part of the solution or part of the problem?", J Psychopharmacol, 20(4 Suppl), pp.79~84 (2006)
- Bremmer MA, "Major depression in late life is associated with both hypo-and hypercortisolemia", Biol Psychiatry, 62, pp.479~486 (2007)
- Stetler C, "Depression and hypothalamic-pituitary-adrenal activation : a quantitative summary of four decades of research", Psycho som Med, 73, pp.114~126 (2011)
- Fries E, "The cortisol awakening response(CAR) : facts and future directions", Int J Psychophysiol, 72, pp.67~73 (2009)
- Clow A, "The cortisol awak ening response : more than a measure of HPA axis function", Neurosci Biobehav Rev, 35, pp.97~103 (2010)
- Clow A, "The cortisol awakening response in context", Int Rev Neurobiol, 93, pp.153~175 (2010)
- Chida Y, "Cortisol awakening response and psychosocial factors : a systematic review and meta-analysis", Biol Psychol, 80, pp.265~278 (2009)
- Veen G, "Basal cortisol levels in relation to dimensions and DSM-IV categories of depression and anxiety", Psychiatry Res, 185, pp.121~128 (2011)
- Vreeburg SA, "Salivary cortisol levels and the 2-year course of depres sive and anxiety disorders", Psychoneuroendocrinology, 38, pp.14941502~ (2013)
- Beck AT, "Psychometric properties of the Beck depression inventory : twenty-five years of evaluation", Clin Psychol Rev, 8, pp.77~100 (1988)
- Rush AJ, "The 16-item quick inventory of depressive symptomatology(QIDS), clinician rating(QIDS-C), and self-report(QIDS-SR) : a psy chometric evaluation in patients with chronic major depression", Biol Psychiatry, 54, pp.573~583 (2003)
- Giano Z, "ACE domains and depression : investigating which specific domains are as sociated with depression in adulthood", Child Abuse Negl, 122, pp.105335~ (2021)
- Marganska A, "Adult attachment, emotion dysregulation, and symptoms of depression and generalized anxiety disorder", Am J Orthopsychiatry, 83, pp.131~141 (2013)
- Fischer-Kern M, "Mentalization and depression : theoretical concepts, treatment approaches and empirical studies–an overview", Z Psychosom Med Psychother, 65, pp.162~177 (2019)
- Waugh CE, "A resilience framework for promoting stable remission from depression", Clin Psychol Rev, 41, pp.49~60 (2015)
- Lee JY, "Development of the battery test for screening of depression and mental health : PROtective and Vulnerable factors battEry Test(PROVE)", J Korean Neuropsychiatr Assoc, 60, pp.143~157 (2021)
- Reivich K, "The resilience factor: 7 essential skills for over coming life’s inevitable obstacles" (2002), Broadway Books
- Kim J, "Resilience" (2019), Wisdomhouse
- Shin WY, "Developing measures of resilience for Korean adolescents and testing cross, convergent, and discriminant validity", Stud Korean Youth, 20, pp.105~131 (2009)
- Goodyer IM, "Possible role of corti sol and dehydroepiandrosterone in human development and psycho pathology", Br J Psychiatry, 179, pp.243~249 (2001)
- Hong JP, "Reliability and validity study of the Korean self rating version of quick inventory of depressive symp tomatology(K-QIDS-SR)", Mood Emot, 11, pp.44~50 (2013)
- Yi JS, "Validity and reliability of the Korean version of the Hamilton depression rating scale(K-HDRS)", J Korean Neuropsychiatr Assoc, 44, pp.456~465 (2005)
- Lee SH, "Validation of the Korean version of the generalized anxiety disorder 7 self-rating scale", Asia Pac Psychiatry, 14, pp.e12421~ (2022)
- Lee J, "The reliability and validity studies of the Korean version of the perceived stress scale", Korean J Psychom Med, 20, pp.127~134 (2012)
- Jang S, "Relationship of resil ience factors with biopsychosocial markers using a comprehensive home evaluation kit for depression and suicide risk : a real-world data analysis", Front Psychiatry, 13, pp.847498~ (2022)
- Dedovic K, "The cortisol awakening response and major de pression : examining the evidence", Neuropsychiatr Dis Treat, 11, pp.1181~1189 (2015)
- Hardeveld F, "Increased cortisol awakening response was associated with time to recurrence of major depressive disorder", Psychoneuroendocrinology, 50, pp.62~71 (2014)
- Gold PW, "Organization of the stress system and its dys regulation in melancholic and atypical depression : high vs low CRH", NE states, 2002, pp.7, 254~275
- Stewart JW, "Defining the boundar ies of atypical depression : evidence from the HPA axis supports course of illness distinctions", J Affect Disord, 86, pp.161~167 (2005)
- Parker G, "Atypical depression : a reappraisal", Am J Psychiatry, 159, pp.14701479~ (2002)
- O’Keane V, "A review of atypical depression in rela tion to the course of depression and changes in HPA axis organization", Psychoneuroendocrinology, 37, pp.1589~1599 (2012)
- Meinlschmidt G, "Decreased cortisol awakening response af ter early loss experience", Psychoneuroendocrinology, 30, pp.568~576 (2005)
- Baes Cv, "Early life stress in de pressive patients : HPA axis response to GR and MR agonist", Front Psychiatry, 5, pp.2~ (2014)
- Iob E, "Adverse childhood experi ences, daytime salivary cortisol, and depressive symptoms in early adulthood : a longitudinal genetically informed twin study", Transl Psychiatry, 11, pp.420~ (2021)
- Fogelman N, "Early life stress and cortisol : a meta-analysis", Horm Behav, 98, pp.63~76 (2018)
- Dorn LD, "Salivary cortisol reflects se rum cortisol : analysis of circadian profiles", Ann Clin Biochem, 44(Pt 3), pp.281~284 (2007)
- Gozansky WS, "Salivary corti sol determined by enzyme immunoassay is preferable to serum total cortisol for assessment of dynamic hypothalamic–pituitary–adrenal axis activity", Clin Endocrinol(Oxf), 63, pp.336~341 (2005)
