Abstract：
BACKGROUND: The binary major depressive disorder (MDD) diagnosis is inadequate and should never be used in research.
OBJECTIVE: The study\'s objective is to explicate our novel precision nomothetic strategy for constructing depression models based on adverse childhood experiences (ACEs), lifetime and current phenome, and biomarker (atherogenicity indices) scores.
METHODS: This study assessed recurrence of illness (ROI: namely recurrence of depressive episodes and suicidal behaviors, SBs), lifetime and current SBs and the phenome of depression, neuroticism, dysthymia, anxiety disorders, and lipid biomarkers including apolipoprotein (Apo)A, ApoB, free cholesterol and cholesteryl esters, triglycerides, high density lipoprotein cholesterol in 67 normal controls and 66 MDD patients. We computed atherogenic and reverse cholesterol transport indices.
RESULTS: We were able to extract one factor from a) the lifetime phenome of depression comprising ROI, and traits such as neuroticism, dysthymia and anxiety disorders, and b) the phenome of the acute phase (based on depression, anxiety and quality of life scores). PLS analysis showed that 55.7 % of the variance in the lifetime + current phenome factor was explained by increased atherogenicity, neglect and sexual abuse, while atherogenicity partially mediated the effects of neglect. Cluster analysis generated a cluster of patients with major dysmood disorder, which was externally validated by increased atherogenicity and characterized by increased scores of all clinical features.
CONCLUSIONS: The outcome of depression should not be represented as a binary variable (MDD or not), but rather as multiple dimensional scores based on biomarkers, ROI, subclinical depression traits, and lifetime and current phenome scores including SBs.
OBJECTIVE: The study\'s objective is to explicate our novel precision nomothetic strategy for constructing depression models based on adverse childhood experiences (ACEs), lifetime and current phenome, and biomarker (atherogenicity indices) scores.
METHODS: This study assessed recurrence of illness (ROI: namely recurrence of depressive episodes and suicidal behaviors, SBs), lifetime and current SBs and the phenome of depression, neuroticism, dysthymia, anxiety disorders, and lipid biomarkers including apolipoprotein (Apo)A, ApoB, free cholesterol and cholesteryl esters, triglycerides, high density lipoprotein cholesterol in 67 normal controls and 66 MDD patients. We computed atherogenic and reverse cholesterol transport indices.
RESULTS: We were able to extract one factor from a) the lifetime phenome of depression comprising ROI, and traits such as neuroticism, dysthymia and anxiety disorders, and b) the phenome of the acute phase (based on depression, anxiety and quality of life scores). PLS analysis showed that 55.7 % of the variance in the lifetime + current phenome factor was explained by increased atherogenicity, neglect and sexual abuse, while atherogenicity partially mediated the effects of neglect. Cluster analysis generated a cluster of patients with major dysmood disorder, which was externally validated by increased atherogenicity and characterized by increased scores of all clinical features.
CONCLUSIONS: The outcome of depression should not be represented as a binary variable (MDD or not), but rather as multiple dimensional scores based on biomarkers, ROI, subclinical depression traits, and lifetime and current phenome scores including SBs.
摘要：
背景：二元重度抑郁症（MDD）的诊断是不充分的，不应在研究中使用。
目的：这项研究的目的是阐明我们新颖的精确理论策略，用于根据不良童年经历（ACE）构建抑郁症模型，寿命和当前的现象，和生物标志物（动脉粥样硬化指数）评分。
方法：这项研究评估了疾病的复发（ROI：即抑郁发作和自杀行为的复发），一生和当前的自杀行为和抑郁症的现象，神经质,心境恶劣,焦虑症,和脂质生物标志物(包括ApoA，ApoB,游离胆固醇和胆固醇酯，甘油三酯，高密度脂蛋白胆固醇）在67名正常对照组和66名MDD患者中。我们计算了致动脉粥样硬化和反向胆固醇转运指数。
结果：我们能够从a）抑郁症的终生表型中提取一个因素，包括ROI，和神经质等特征，心境恶劣和焦虑症，和b)急性期的表型(基于抑郁症，焦虑和生活质量评分)。PLS分析表明，寿命+当前表型因子的55.7%的变异是由动脉粥样硬化增加解释的，忽视和性虐待，而动脉粥样硬化部分介导了忽视的影响。聚类分析产生了一组患有严重情绪障碍的患者，这通过动脉粥样硬化增加进行了外部验证，并以所有临床特征的得分增加为特征。
结论：抑郁症的结果不应表示为二元变量（MDD与否），而是基于生物标志物的多维评分，ROI,亚临床抑郁特征，以及包括自杀行为在内的终生和当前表型评分。
目的：这项研究的目的是阐明我们新颖的精确理论策略，用于根据不良童年经历（ACE）构建抑郁症模型，寿命和当前的现象，和生物标志物（动脉粥样硬化指数）评分。
方法：这项研究评估了疾病的复发（ROI：即抑郁发作和自杀行为的复发），一生和当前的自杀行为和抑郁症的现象，神经质,心境恶劣,焦虑症,和脂质生物标志物(包括ApoA，ApoB,游离胆固醇和胆固醇酯，甘油三酯，高密度脂蛋白胆固醇）在67名正常对照组和66名MDD患者中。我们计算了致动脉粥样硬化和反向胆固醇转运指数。
结果：我们能够从a）抑郁症的终生表型中提取一个因素，包括ROI，和神经质等特征，心境恶劣和焦虑症，和b)急性期的表型(基于抑郁症，焦虑和生活质量评分)。PLS分析表明，寿命+当前表型因子的55.7%的变异是由动脉粥样硬化增加解释的，忽视和性虐待，而动脉粥样硬化部分介导了忽视的影响。聚类分析产生了一组患有严重情绪障碍的患者，这通过动脉粥样硬化增加进行了外部验证，并以所有临床特征的得分增加为特征。
结论：抑郁症的结果不应表示为二元变量（MDD与否），而是基于生物标志物的多维评分，ROI,亚临床抑郁特征，以及包括自杀行为在内的终生和当前表型评分。
