PsiOvi Staging Model for Schizophrenia (PsiOvi SMS): A New Internet Tool for Staging Patients with Schizophrenia

Abstract

Background: One of the challenges of psychiatry is the staging of patients, especially those with severe mental disorders. Therefore, we aim to develop an empirical staging model for schizophrenia.

Methods: Data were obtained from 212 stable outpatients with schizophrenia: demographic, clinical, psychometric (PANSS, CAINS, CDSS, OSQ, CGI-S, PSP, MATRICS), inflammatory peripheral blood markers (C-reactive protein, interleukins-1RA and 6, and platelet/lymphocyte [PLR], neutrophil/lymphocyte [NLR], and monocyte/lymphocyte [MLR] ratios). We used machine learning techniques to develop the model (genetic algorithms, support vector machines) and applied a fitness function to measure the model's accuracy (% agreement between patient classification of our model and the CGI-S).

Results: Our model includes 12 variables from 5 dimensions: 1) psychopathology: positive, negative, depressive, general psychopathology symptoms; 2) clinical features: number of hospitalizations; 3) cognition: processing speed, visual learning, social cognition; 4) biomarkers: PLR, NLR, MLR; and 5) functioning: PSP total score. Accuracy was 62% (SD = 5.3), and sensitivity values were appropriate for mild, moderate, and marked severity (from 0.62106 to 0.6728).

Discussion: We present a multidimensional, accessible, and easy-to-apply model that goes beyond simply categorizing patients according to CGI-S score. It provides clinicians with a multifaceted patient profile that facilitates the design of personalized intervention plans.

Keywords: clinical tool; empirical staging model; multidimensional model; personalized intervention; schizophrenia.

Figure 1.

Flowchart of the algorithm employed in this research. GA Genetic Algorithm.

Figure 2.

Development of our model using Machine-Learning techniques. CGI-S Clinical Global Impression-Schizophrenia Severity.

Figure 3.

Variables included in the staging model. PANSS Positive and Negative Syndrome Scale, PANSS-P Positive, PANSS-MNF Marder Negative Factor, PANSS-GP General Psychopathology, CDSS Calgary Depression Scale for Schizophrenia, TMT A Trail Making Test A, BVMT-R Brief Visuospatial Memory Test Revised, MSCEIT Mayer-Salovey-Caruso Emotional Intelligence Test: Managing Emotions, PLR Platelets/lymphocytes Ratio, MLR Monocytes/lymphocytes Ratio, NLR Neutrophils/lymphocytes Ratio; PSP-Total: Personal and Social Performance Total score.