. 2025 Jun 15:379:889-899.

doi: 10.1016/j.jad.2024.12.053. Epub 2024 Dec 17.

Machine learning models for diagnosis and risk prediction in eating disorders, depression, and alcohol use disorder

Zuo Zhang¹, Lauren Robinson², Robert Whelan³, Lee Jollans³, Zijian Wang⁴, Frauke Nees⁵, Congying Chu⁶, Marina Bobou⁷, Dongping Du⁸, Ilinca Cristea⁹, Tobias Banaschewski¹⁰, Gareth J Barker¹¹, Arun L W Bokde¹², Antoine Grigis¹³, Hugh Garavan¹⁴, Andreas Heinz¹⁵, Rüdiger Brühl¹⁶, Jean-Luc Martinot¹⁷, Marie-Laure Paillère Martinot¹⁸, Eric Artiges¹⁹, Dimitri Papadopoulos Orfanos¹³, Luise Poustka²⁰, Sarah Hohmann¹⁰, Sabina Millenet¹⁰, Juliane H Fröhner²¹, Michael N Smolka²¹, Nilakshi Vaidya²², Henrik Walter¹⁵, Jeanne Winterer²³, M John Broulidakis²⁴, Betteke Maria van Noort²⁵, Argyris Stringaris²⁶, Jani Penttilä²⁷, Yvonne Grimmer¹⁰, Corinna Insensee²⁰, Andreas Becker²⁰, Yuning Zhang²⁸, Sinead King²⁹, Julia Sinclair³⁰, Gunter Schumann³¹, Ulrike Schmidt³², Sylvane Desrivières³³

Affiliations

¹ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK.
² Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, London, UK; Oxford Institute of Clinical Psychology Training and Research, Oxford University, Oxford, UK.
³ School of Psychology and Global Brain Health Institute, Trinity College Dublin, Ireland.
⁴ School of Computer Science and Technology, Donghua University, Shanghai, China.
⁵ Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany; Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany; Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany.
⁶ University of Chinese Academy of Sciences, 100190 Beijing, China; Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, 100190 Beijing, China; National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, 100190 Beijing, China.
⁷ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
⁸ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; Department of Electrical and Computer Engineering, Virginia Polytechnic Institute and State University, Arlington, VA 22203, USA.
⁹ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK.
¹⁰ Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany.
¹¹ Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
¹² Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
¹³ NeuroSpin, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France.
¹⁴ Departments of Psychiatry and Psychology, University of Vermont, 05405 Burlington, VT, USA.
¹⁵ Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany.
¹⁶ Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany.
¹⁷ Institut National de la Santé et de la Recherche Médicale, INSERM U1299 "Developmental trajectories & psychiatry", Université Paris-Saclay, Université Paris Cité, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli UMR9010, Gif-sur-Yvette, France.
¹⁸ Institut National de la Santé et de la Recherche Médicale, INSERM U1299 "Developmental trajectories & psychiatry", Université Paris-Saclay, Université Paris Cité, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli UMR9010, Gif-sur-Yvette, France; AP-HP, Sorbonne Université, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France.
¹⁹ Institut National de la Santé et de la Recherche Médicale, INSERM U1299 "Developmental trajectories & psychiatry", Université Paris-Saclay, Université Paris Cité, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli UMR9010, Gif-sur-Yvette, France; Psychiatry Department, EPS Barthélemy Durand, Etampes, France.
²⁰ Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, von-Siebold-Str. 5, 37075 Göttingen, Germany.
²¹ Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany.
²² Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany.
²³ Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany; Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.
²⁴ Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Department of Psychology, College of Science, Northeastern University, Boston, MA, USA.
²⁵ Department of Psychology, MSB Medical School Berlin, Rüdesheimer Str. 50, 14197 Berlin, Germany.
²⁶ Division of Psychiatry and Department of Clinical, Educational & Health Psychology, University College London, UK.
²⁷ Department of Social and Health Care, Psychosocial Services Adolescent Outpatient Clinic Kauppakatu 14, Lahti, Finland.
²⁸ Psychology Department, B44 University Rd, University of Southampton, Southampton SO17 1PS, UK.
²⁹ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; School of Medicine, Centre for Neuroimaging, Cognition and Genomics, National University of Ireland (NUI), Galway, Ireland; Beaumont Hospital, Royal College of Surgeons, Ireland.
³⁰ Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
³¹ Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany; Centre for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China.
³² Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, London, UK.
³³ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK. Electronic address: sylvane.desrivieres@kcl.ac.uk.

PMID: 39701465
PMCID: PMC7617286
DOI: 10.1016/j.jad.2024.12.053

Machine learning models for diagnosis and risk prediction in eating disorders, depression, and alcohol use disorder

Zuo Zhang et al. J Affect Disord. 2025.

. 2025 Jun 15:379:889-899.

doi: 10.1016/j.jad.2024.12.053. Epub 2024 Dec 17.

Authors

Affiliations

¹ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK.
² Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, London, UK; Oxford Institute of Clinical Psychology Training and Research, Oxford University, Oxford, UK.
³ School of Psychology and Global Brain Health Institute, Trinity College Dublin, Ireland.
⁴ School of Computer Science and Technology, Donghua University, Shanghai, China.
⁵ Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany; Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, Mannheim, Germany; Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany.
⁶ University of Chinese Academy of Sciences, 100190 Beijing, China; Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, 100190 Beijing, China; National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, 100190 Beijing, China.
⁷ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
⁸ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; Department of Electrical and Computer Engineering, Virginia Polytechnic Institute and State University, Arlington, VA 22203, USA.
⁹ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK.
¹⁰ Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Square J5, 68159 Mannheim, Germany.
¹¹ Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
¹² Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
¹³ NeuroSpin, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France.
¹⁴ Departments of Psychiatry and Psychology, University of Vermont, 05405 Burlington, VT, USA.
¹⁵ Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany.
¹⁶ Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany.
¹⁷ Institut National de la Santé et de la Recherche Médicale, INSERM U1299 "Developmental trajectories & psychiatry", Université Paris-Saclay, Université Paris Cité, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli UMR9010, Gif-sur-Yvette, France.
¹⁸ Institut National de la Santé et de la Recherche Médicale, INSERM U1299 "Developmental trajectories & psychiatry", Université Paris-Saclay, Université Paris Cité, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli UMR9010, Gif-sur-Yvette, France; AP-HP, Sorbonne Université, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France.
¹⁹ Institut National de la Santé et de la Recherche Médicale, INSERM U1299 "Developmental trajectories & psychiatry", Université Paris-Saclay, Université Paris Cité, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli UMR9010, Gif-sur-Yvette, France; Psychiatry Department, EPS Barthélemy Durand, Etampes, France.
²⁰ Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, von-Siebold-Str. 5, 37075 Göttingen, Germany.
²¹ Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany.
²² Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany.
²³ Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charitéplatz 1, Berlin, Germany; Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.
²⁴ Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Department of Psychology, College of Science, Northeastern University, Boston, MA, USA.
²⁵ Department of Psychology, MSB Medical School Berlin, Rüdesheimer Str. 50, 14197 Berlin, Germany.
²⁶ Division of Psychiatry and Department of Clinical, Educational & Health Psychology, University College London, UK.
²⁷ Department of Social and Health Care, Psychosocial Services Adolescent Outpatient Clinic Kauppakatu 14, Lahti, Finland.
²⁸ Psychology Department, B44 University Rd, University of Southampton, Southampton SO17 1PS, UK.
²⁹ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; School of Medicine, Centre for Neuroimaging, Cognition and Genomics, National University of Ireland (NUI), Galway, Ireland; Beaumont Hospital, Royal College of Surgeons, Ireland.
³⁰ Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
³¹ Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany; Centre for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China.
³² Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; South London and Maudsley NHS Foundation Trust, London, UK.
³³ Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK. Electronic address: sylvane.desrivieres@kcl.ac.uk.

PMID: 39701465
PMCID: PMC7617286
DOI: 10.1016/j.jad.2024.12.053

Abstract

Background: Early diagnosis and treatment of mental illnesses is hampered by the lack of reliable markers. This study used machine learning models to uncover diagnostic and risk prediction markers for eating disorders (EDs), major depressive disorder (MDD), and alcohol use disorder (AUD).

Methods: Case-control samples (aged 18-25 years), including participants with Anorexia Nervosa (AN), Bulimia Nervosa (BN), MDD, AUD, and matched controls, were used for diagnostic classification. For risk prediction, we used a longitudinal population-based sample (IMAGEN study), assessing adolescents at ages 14, 16 and 19. Regularized logistic regression models incorporated broad data domains spanning psychopathology, personality, cognition, substance use, and environment.

Results: The classification of EDs was highly accurate, even when excluding body mass index from the analysis. The area under the receiver operating characteristic curves (AUC-ROC [95 % CI]) reached 0.92 [0.86-0.97] for AN and 0.91 [0.85-0.96] for BN. The classification accuracies for MDD (0.91 [0.88-0.94]) and AUD (0.80 [0.74-0.85]) were also high. The models demonstrated high transdiagnostic potential, as those trained for EDs were also accurate in classifying AUD and MDD from healthy controls, and vice versa (AUC-ROCs, 0.75-0.93). Shared predictors, such as neuroticism, hopelessness, and symptoms of attention-deficit/hyperactivity disorder, were identified as reliable classifiers. In the longitudinal population sample, the models exhibited moderate performance in predicting the development of future ED symptoms (0.71 [0.67-0.75]), depressive symptoms (0.64 [0.60-0.68]), and harmful drinking (0.67 [0.64-0.70]).

Conclusions: Our findings demonstrate the potential of combining multi-domain data for precise diagnostic and risk prediction applications in psychiatry.

Keywords: Alcohol use disorder; Eating disorders; Major depressive disorder; Predictive modeling; Risk factors.

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Conflict of interest statement

Declaration of competing interest Dr. Banaschewski served in an advisory or consultancy role for Lundbeck, Medice, Neurim Pharmaceuticals, Oberberg GmbH, Shire. He received conference support or speaker's fee by Lilly, Medice, Novartis and Shire. He has been involved in clinical trials conducted by Shire & Viforpharma. He received royalties from Hogrefe, Kohlhammer, CIP Medien, Oxford University Press. Dr. Barker has received honoraria from General Electric Healthcare for teaching on scanner programming courses. Dr. Poustka served in an advisory or consultancy role for Roche and Viforpharm and received speaker's fee by Shire. She received royalties from Hogrefe, Kohlhammer and Schattauer. M. John Broulidakis receives a salary from medical device manufacturer Emteq Labs for which he works as a research scientist. Emteq Labs had no role, financial or otherwise, in the STRATIFY or IMAGEN projects or this paper in particular. Views expressed in this paper do not necessarily reflect those of Emteq Labs. The present work is unrelated to the above grants and relationships. The other authors report no biomedical financial interests or potential conflicts of interest.

Figures

**Figure 1**
Classification performance on the AN, BN, and HC samples. Asterisks (*) indicate the performance is significantly above chance after correction with a false discovery rate (FDR) <0.05 for the 24 tests. Error bars indicate 95% bootstrap confidence intervals. Dashed lines indicate chance level performance (0.5). ROC curve, receiver operating characteristic curve. AN, anorexia nervosa. BN, bulimia nervosa. HC, healthy controls.

**Figure 2**
Top 10 reliable features identified from the classification model involving all data domains except BMI. Features are listed if they were among the top 10 reliable features for at least one analysis. Top 10 reliable features are indicated by solid circles. All the features were standardized as z-scores. Feature importance was measured by calculating the median value of the model coefficients across all the cross-validation folds. AN, anorexia nervosa. BN, bulimia nervosa. HC, healthy controls. ADHD, Attention-deficit/hyperactivity disorder. GAD, Generalized anxiety disorder. OCD, Obsessive compulsive disorder. CGT, Cambridge gambling task. SWM, spatial working memory.

**Figure 3**
Top 10 reliable features identified from the classification between MDD, AUD, and HC. Features are listed if they were among the top 10 reliable features for at least one analysis. Top 10 reliable features are indicated by solid circles. All the features were standardized as z-scores. AUD, alcohol use disorder. MDD, major depressive disorder. HC, healthy controls. ADHD, Attention-deficit/hyperactivity disorder. GAD, Generalized anxiety disorder. OCD, Obsessive compulsive disorder.

**Figure 4**
Results of predicting the development of mental health symptoms (A) and top 10 reliable predictors (B). Features are listed if they were among the top 10 reliable features for at least one analysis. Top 10 reliable features are indicated by solid circles. All the features except sex were standardized as z-scores. ROC curve, receiver operating characteristic curve. PDS, pubertal development scale. ADHD, attention-deficit/hyperactivity disorder. OCD, Obsessive compulsive disorder.

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Update of

Machine learning models for diagnosis and risk prediction in eating disorders, depression, and alcohol use disorder.
Desrivières S, Zhang Z, Robinson L, Whelan R, Jollans L, Wang Z, Nees F, Chu C, Bobou M, Du D, Cristea I, Banaschewski T, Barker G, Bokde A, Grigis A, Garavan H, Heinz A, Bruhl R, Martinot JL, Martinot MP, Artiges E, Orfanos DP, Poustka L, Hohmann S, Millenet S, Fröhner J, Smolka M, Vaidya N, Walter H, Winterer J, Broulidakis M, van Noort B, Stringaris A, Penttilä J, Grimmer Y, Insensee C, Becker A, Zhang Y, King S, Sinclair J, Schumann G, Schmidt U. Desrivières S, et al. Res Sq [Preprint]. 2024 Feb 1:rs.3.rs-3777784. doi: 10.21203/rs.3.rs-3777784/v1. Res Sq. 2024. Update in: J Affect Disord. 2025 Jun 15;379:889-899. doi: 10.1016/j.jad.2024.12.053. PMID: 38352452 Free PMC article. Updated. Preprint.

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Machine learning models for diagnosis and risk prediction in eating disorders, depression, and alcohol use disorder

Affiliations

Machine learning models for diagnosis and risk prediction in eating disorders, depression, and alcohol use disorder

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Update of

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical