Table 2.
Clinical Predictive Models in Precision Psychiatry
| Outcome | Sample | Classification Methods | Best Performance | Most Relevant Predictors | Reference |
|---|---|---|---|---|---|
| BD | |||||
| Response to lithium (CGI-BP for overall BD illness at 6 months) | 240 outpatients with BD-I or BD-II receiving adjunctive personalized treatment plus either lithium or quetiapine | ENR | Accuracy: 17% | Non-suicidal self-injurious behaviour, ADHD, high levels of mania, of social phobia/anxiety disorder, suicide risk | Kim et al (2019)22 |
| Long-term lithium response (minimum duration of treatment: 1 year) | 1266 patients with BD from seven international specialist clinics | RF | Sensitivity: 0.53 Specificity: 0.90 |
Episodic clinical course | Nunes et al (2020)23 |
| Short-term lithium response (8 weeks) | 20 patients with first-episode bipolar mania | Genetic fuzzy tree | Accuracy: 80% | fMRI and 1H-MRS scans | Fleck et al (2017)24 |
| MDD | |||||
| Treatment-resistant depression | 2555 patients with MDD included in the STAR*D study | Naïve Bayes classifier, RF, SVM | ROC AUC: 0.71 | QIDS score, demographic variables, comorbidity with PTSD, recurrent episodes, psychosis screen positive | Perlis (2013)25 |
| Treatment-resistant depression | 2782 patients with MDD included in the STAR*D study; 225 patients with MDD included in the RIS-INT-93 study | K-means clustering, penalized LR RF, GBDT, XGBoost ENR | Accuracy: 0.70 | Items from QIDS, SHFS, PDSQ, PRISE and WSAS | Nie et al (2018)26 |
| SCZ | |||||
| Subgroups of patients with homogeneous characteristics | 104 patients with SCZ | Hierarchical clustering, LR, SVM, RM | ROC AUC: 0.81 | T1-weighted MRI data, items from SAPS/SANS | Talpalaru et al (2019)27 |
| First episode psychosis or conversion to psychosis within 12 months | 347 participants from eight early psychosis clinics | Spectral clustering analysis, SVM | PPV: 76.5% | Items from EPSI and SIPS | Brodey et al (2019)28 |
| Psychotic relapse | 315 patients included in the included in the FondaMental Expert Centers for Schizophrenia network and followed up for two years | Classification and regression trees | Sensitivity: 0.71 Specificity: 0.45 |
High anger (Buss&Perry subscore), high physical aggressiveness (Buss &Perry scale subscore), high lifetime number of hospitalizations in psychiatry, low education level, PANSS positive subscore at baseline | Fond et al (2019)29 |
| Treatment outcome (GAF score) at 4 weeks and 1 year | 334 patients included in the European First Episode Schizophrenia Trial | Cross validation, SVM | Accuracy: 75% | Unemployment, poor education, functional deficits, unmet psychosocial needs predicted both endpoints; previous depressive episodes, male sex, and suicidality predicted poor 1-year outcomes | Koutsouleris et al (2016)30 |
Abbreviations: ADHD, attention-deficit/hyperactivity disorder; BD, bipolar disorder; BD-I, BD type I; BD-II, BD type 2; CGI-BP, Clinical global impressions scale‐bipolar version; ENR, Elastic net regularization; EPSI, Early Psychosis Screener for Internet; fMRI, functional magnetic resonance imaging; GAF, Global Assessment of Functioning; LR, logistic regression; MDD, major depressive disorder; MRS, magnetic resonance spectroscopy; PANSS, Positive and Negative Syndrome Scale; PDSQ, Psychiatric Diagnostic Screening Questionnaire; PPV, positive predictive value; PRISE, The Patient Rated Inventory of Side Effects; QIDS, Quick Inventory of Depressive Symptomatology; Ref, reference; RF, random forest; ROC AUC, area under the receiver operating characteristic curve; SANS, Scale for the Assessment of Negative Symptoms; SAPS, Scale for the Assessment of Positive Symptoms; SCZ, schizophrenia; SFHS, Short Form Health Survey; SIPS, Structured Interview for Psychosis-Risk Syndromes; STAR*D, Sequenced Treatment Alternatives to Relieve Depression; SVM, support vector machine; WSAS, The Work and Social Adjustment Scale.