Exploratory Clinical Trial of a Depression Diagnostic Software That Integrates Stress Biomarkers and Composite Psychometrics

• Published in: Psychiatry investigation Vol. 21; no. 3; pp. 230 - 241
• Main Authors: Jang, Sooah, Kim, In-Young, Choi, Sun-Woo, Lee, Anna, Lee, Ju-Yeal, Shin, Hyunkyung, Lee, Junwoo, Lee, Mikyeong, Lee, Kyoung-Ryul, Jung, Saeeun, Ryu, Jin Sun, Oh, Jihee, Kwon, Manjae, Kim, Joohan, Ahn, Ryunsup, Jung, Young-Chul, Seok, Jeong-Ho
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Neuropsychiatric Association 01.03.2024; 대한신경정신의학회
• Subjects: Original; 정신과학; Depression; Biomarker; Cortisol; Diagnosis; Salivary hormone; Hypothalamic–pituitary–adrenal axis
• ISSN: 1738-3684; 1976-3026
• DOI: 10.30773/pi.2023.0253

This study evaluated the clinical effectiveness of Minds.NAVI, a depression screening kit combining psychometric measures and stress hormone biomarkers, in a prospective clinical trial. The objective was to assess its potential as a depression screening tool and investigate the associations between psychological assessments, salivary hormone staging, and depression severity. Thirty-five participants with major depressive disorder and 12 healthy controls (HCs) were included. The Minds.NAVI software, utilizing the PROtective and Vulnerable factors battEry Test (PROVE) and salivary cortisol/dehydroepiandrosterone (DHEA) analysis, was employed. The PROVE test is a comprehensive self-report questionnaire that assesses depressive symptoms, suicide risk, attachment style, adverse childhood experiences, mentalization capacity, and resilience. In addition, salivary cortisol and DHEA levels were measured to evaluate the functional stage of the hypothalamic-pituitary-adrenal (HPA) axis. Minds.NAVI exhibited 100% sensitivity, 91.7% specificity, and 97.9% accuracy in distinguishing depression from HCs within an exploratory small group. Salivary stress hormone phases showed changes with depression stage (p=0.030), and the proportion of patients with "adrenal exhaustion stage" was higher in the moderate/severe depression group (p=0.038). Protective/vulnerable factors differed significantly between controls and depressed groups (p<0.001). Cortisol awakening response inversely correlated with depressive symptom severity (r=-0.31, p=0.034). This study suggested possible clinical effectiveness of Minds.NAVI, a depression screening tool that integrates psychometric measures and stress hormone biomarkers. The findings support the potential association between depression, chronic stress, and HPA axis hyporesponsiveness.