Screening for PTSD and TBI in Veterans using Routine Clinical Laboratory Blood Tests.

Autor: Xu M; Center for Precision Medicine in Alcohol Use Disorder and PTSD, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA., Lin Z; Center for Precision Medicine in Alcohol Use Disorder and PTSD, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA., Siegel CE; Center for Precision Medicine in Alcohol Use Disorder and PTSD, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Steven and Alexandra Cohen Veteran Center for the Study of PTSD and TBI, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA., Laska EM; Center for Precision Medicine in Alcohol Use Disorder and PTSD, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Steven and Alexandra Cohen Veteran Center for the Study of PTSD and TBI, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA., Abu-Amara D; Center for Precision Medicine in Alcohol Use Disorder and PTSD, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Steven and Alexandra Cohen Veteran Center for the Study of PTSD and TBI, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA., Genfi A; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Steven and Alexandra Cohen Veteran Center for the Study of PTSD and TBI, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA., Newman J; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Steven and Alexandra Cohen Veteran Center for the Study of PTSD and TBI, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA., Jeffers MK; Center for Precision Medicine in Alcohol Use Disorder and PTSD, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Steven and Alexandra Cohen Veteran Center for the Study of PTSD and TBI, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA., Blessing EM; Center for Precision Medicine in Alcohol Use Disorder and PTSD, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Steven and Alexandra Cohen Veteran Center for the Study of PTSD and TBI, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA., Flanagan SR; Center for Precision Medicine in Alcohol Use Disorder and PTSD, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Steven and Alexandra Cohen Veteran Center for the Study of PTSD and TBI, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Rusk Rehabilitation Institute, Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, NY, USA., Fossati S; Center for Precision Medicine in Alcohol Use Disorder and PTSD, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Steven and Alexandra Cohen Veteran Center for the Study of PTSD and TBI, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Department of Pharmacology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.; Alzheimer's Center at Temple, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA., Etkin A; Center for Precision Medicine in Alcohol Use Disorder and PTSD, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Steven and Alexandra Cohen Veteran Center for the Study of PTSD and TBI, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.; Alto Neuroscience, Los Altos, CA, USA., Marmar CR; Center for Precision Medicine in Alcohol Use Disorder and PTSD, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA. Charles.Marmar@nyulangone.org.; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA. Charles.Marmar@nyulangone.org.; Steven and Alexandra Cohen Veteran Center for the Study of PTSD and TBI, Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA. Charles.Marmar@nyulangone.org.
Jazyk: angličtina
Zdroj: Translational psychiatry [Transl Psychiatry] 2023 Feb 21; Vol. 13 (1), pp. 64. Date of Electronic Publication: 2023 Feb 21.
DOI: 10.1038/s41398-022-02298-x
Abstrakt: Post-traumatic stress disorder (PTSD) is a mental disorder diagnosed by clinical interviews, self-report measures and neuropsychological testing. Traumatic brain injury (TBI) can have neuropsychiatric symptoms similar to PTSD. Diagnosing PTSD and TBI is challenging and more so for providers lacking specialized training facing time pressures in primary care and other general medical settings. Diagnosis relies heavily on patient self-report and patients frequently under-report or over-report their symptoms due to stigma or seeking compensation. We aimed to create objective diagnostic screening tests utilizing Clinical Laboratory Improvement Amendments (CLIA) blood tests available in most clinical settings. CLIA blood test results were ascertained in 475 male veterans with and without PTSD and TBI following warzone exposure in Iraq or Afghanistan. Using random forest (RF) methods, four classification models were derived to predict PTSD and TBI status. CLIA features were selected utilizing a stepwise forward variable selection RF procedure. The AUC, accuracy, sensitivity, and specificity were 0.730, 0.706, 0.659, and 0.715, respectively for differentiating PTSD and healthy controls (HC), 0.704, 0.677, 0.671, and 0.681 for TBI vs. HC, 0.739, 0.742, 0.635, and 0.766 for PTSD comorbid with TBI vs HC, and 0.726, 0.723, 0.636, and 0.747 for PTSD vs. TBI. Comorbid alcohol abuse, major depressive disorder, and BMI are not confounders in these RF models. Markers of glucose metabolism and inflammation are among the most significant CLIA features in our models. Routine CLIA blood tests have the potential for discriminating PTSD and TBI cases from healthy controls and from each other. These findings hold promise for the development of accessible and low-cost biomarker tests as screening measures for PTSD and TBI in primary care and specialty settings.
(© 2023. The Author(s).)
Databáze: MEDLINE
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