2020-02-13

025_ Multimodal stratification and comorbidity analysis in the PsyCourse sample using cross sectional approach (Pilot Study).

Research Question and Aims

People with psychosis have an elevated risk of depression and type 2 diabetes (T2D), cardiovascular diseases (CVD), neurodegenrative diseases but no large-scale study has characterized their comorbidity effects. The project (Commitment grant) is designed to develop psychotic disorder stratification profiles that measure the course of biological risk and treatment-relevant dimensions as well as common biological determinants with comorbid conditions. It will develop a system of disease-overarching, multidisciplinary and translational research based on disengaging the psychotic underlying biological heterogeneity and defining pathways associated with specific somatic comorbidities. The overarching goal is to investigate the comorbidity association between subgroups in psychosis and cardio vascular as well as metabolomic diseases. This will help us stratify patients with psychotic disorders and identify shared biological domains with somatic comorbidities.

Analytic Plan

Method: Cross sectional model based clustering

1. Comorbidity analysis between cross sectional symptom specific subgroups (D.Dwyer et al. 2020) and CVD diseases and T2D diseases. We would examine the association between cross sectional symptom specific subgroups [identified by D. Dwyer et al., Jama Psychiatry (2020) (in press)] and clinical dimensions.
2. Cross sectional model-based subtypes using CVD and T2D selected patient and predict (multivariate ensemble learning classification) those subgroups by using clinical baseline items.

Resources needed

Phenotypes: We will be using the dataset from Dominic Dwyer for the pilot study and for the final version we will be using the updated dataset

Sociodemographics (v1_sex, v1_ageBL, v1_yob, v1_seas_birth, v1_center), Marital status (v1_marital_stat), Relationship status, Children, Living alone, Education, Employment
Psychiatric History (v1_cur_psy_trm, v1_outpat_psy_trm, v1_age_1st_out_trm,v1_daypat_inpat_trm, v1_dur_illness,
v1_1st_ep, v1_tms_daypat_outpat_trm, v1_cat_daypat_outpat_trm),

Diagnoses
Questionnaires (SCID, BDI-II, PANSS, LEQ, CTS, IDS-C30, YMRS, GAF, CGI) - Sum scores and single items
Symptom rating scales (SCID, PANSS, IDS-C30, YMRS, GAF, CGI) - Sum scores and single items

Medications
Metabolic Disorder (Type 2 diabetes) (v1_metbl_N_Y)
Cardiovascular Disease (v1_cardvas_N_Y)
PRS score (SCZ, Bipolar, MDD, Cardiovascular Disease, Metabolomic Disease), Imputed genotypes

full list of variables:
'v1_sex_F_M', 'v1_ageBL', 'v1_seas_birth_Fall', 'v1_seas_birth_Spring', 'v1_seas_birth_Summer', 'v1_seas_birth_Winter'
'v1_age_m_birh','v1_age_f_birth', 'v1_marital_stat_Divorced', 'v1_marital_stat_Married', 'v1_marital_stat_Single', 'v1_partner_N_Y'
'v1_no_bio_chld', 'v1_brothers', 'v1_sisters', 'v1_liv_aln_N_Y', 'v1_school', 'v1_ed_status', 'v1_curr_paid_empl_N_Y', 'v1_cur_work_restr_N_Y', 'v1_cur_psy_trm', 'v1_outpat_psy_trm', 'v1_age_1st_out_trm', 'v1_age_1st_inpat_trm', 'v1_dur_illness'
'v1_1st_ep_N_Y', 'v1_tms_daypat_outpat_trm', 'v1_cat_daypat_outpat_trm', 'v1_adv_N_Y', 'v1_medchange_N_Y', 'v1_lith_N_Y','v1_lith_prd', 'v1_fam_hist_N_Y', 'v1_height', 'v1_weight'
'v1_bmi','v1_cardvas_N_Y','v1_metbl_N_Y','v1_thyrd_N_Y','v1_rmd_N_Y','v1_lung_N_Y', 'v1_allerg_N_Y','v1_gastroint_N_Y', 'v1_galleb_N_Y', 'v1_skin_N_Y', 'v1_kibl_N_Y', 'v1_n_psy_N_Y', 'v1_eyear_N_Y', 'v1_inf_N_Y'
'v1_canc_N_Y', 'v1_othr_dis_N_Y','v1_ever_smkd_F','v1_ever_smkd_N','v1_ever_smkd_Y','v1_alc_pst12_mths'
'v1_lftm_alc_dep_N_Y','v1_evr_ill_drg_N_Y','v1_scid_ever_halls_N_Y','v1_scid_ever_delus_N_Y','v1_scid_evr_suic_ide_N_Y'
'v1_scid_suic_ide','v1_scid_suic_thght_mth','v1_scid_suic_note_thgts','v1_suic_attmpt', 'v1_scid_no_suic_attmpt','v1_scid_prep_suic_attp_dic_N_Y'
'v1_scid_prep_suic_attp_ord','v1_scid_suic_note_attmpt', 'v1_panss_p1-p7', 'v1_panss_n1-n7', 'v1_panss_g1-g16', 'v1_panss_sum_pos','v1_panss_sum_neg','v1_panss_sum_gen', 'v1_panss_sum_tot', 'v1_idsc_itm1-30', 'v1_idsc_sum', 'v1_ymrs_itm1-11'
'v1_ymrs_sum', 'v1_cgi_s','v1_gaf', 'v1_nrpsy_lng_good', 'v1_nrpsy_lng_mothertongue', 'v1_nrpsy_tmt_A_rt'
'v1_nrpsy_tmt_A_err','v1_nrpsy_tmt_B_rt','v1_nrpsy_tmt_B_err', 'v1_nrpsy_dgt_sp_frw', 'v1_nrpsy_dgt_sp_bck'
'v1_nrpsy_dg_sym', 'v1_nrpsy_mwtb', 'v1_med_pst_wk', 'v1_med_pst_sx_mths', 'v1_whoqol_itm1-26', 'v1_whoqol_dom_glob', 'v1_whoqol_dom_phys', 'v1_whoqol_dom_psy', 'v1_whoqol_dom_soc','v1_whoqol_dom_env'