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Supervised machine learning to decipher the complex associations between neuro-immune biomarkers and quality of life in schizophrenia

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Abstract

Stable phase schizophrenia is characterized by altered patterning in tryptophan catabolites (TRYCATs) and memory impairments, which are associated with PHEMN (psychosis, hostility, excitation, mannerism and negative) and DAPS (depression, anxiety and physio-somatic) symptoms. This study was carried out to examine the association between TRYCAT patterning, memory impairments, psychopathological features and health-related quality of life (HR-QoL) in schizophrenia. The World Health Organization (WHO) QoL instrument-Abbreviated version (WHO-QoL-BREF), IgA/IgM responses to TRYCATs, cognitive tests, Scale for the Assessment of Negative Symptoms (SANS), Hamilton and Depression (HAMD) and Anxiety (HAMA) Rating Scales and the Fibromyalgia and Chronic Fatigue Syndrome Rating Scale (FF) were measured in 80 schizophrenia patients and 40 controls. Neural Network analysis shows that the total HR-Qol score is best predicted by (in descending order) HAMA, FF, HAMD, and psychosis. Partial least Squares (PLS) analysis shows that 56.7% of the variance in the WHO-QoL scores is explained by PHEMN / DAPS symptoms, while 64.3% of the variance in those symptoms is explained by TRYCAT patterning and episodic/semantic memory impairments. IgA responses to picolinic acid, xanthurenic acid and 3-hydroxy-kynurenine (all negatively) and anthranilic acid (positively) have highly significant indirect effects on WHO-QoL scores, which are completely mediated by cognitive impairments and PHEMN / DAPS symptoms. The results show that lowered HR-Qol in schizophrenia is strongly associated with noxious TRYCATs and that these effects are mediated by impairments in episodic / semantic memory and schizophrenia phenomenology, especially physio-somatic and anxiety symptoms. Mucosal activation of the TRYCAT pathway combined with a deficit in natural IgM isotype antibodies to TRYCATs determine cognitive impairments and DAPS/PHEMN symptoms, which together determine to a large extent lowered HR-QoL in schizophrenia.

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References

  • Abadi M, Agarwal, A, Barham, P, Brevdo, E, Chen, Z, Citro, C, Corrado, G S, Davis, A, Dean J, Devin, M, Ghemawat, S, Goodfellow, I, Harp, A, Irving, G, Isard, M, Jozefowicz, R, Jia, Y, Kaiser, L, Kudlur, M, Levenburg, J, Mane, D, Schuster, M, Monga, R, Moore, S, Murray, D, Olah, C, Shlens, J, Steiner, B, Sutskever, I, Talwar, K, Tucker, P, Vahoucke, V, Vasudevan, C, Viegas, F, Vinyals, O, Warden, P, Wattenerg, M, Wicke, M, Yu, Y, and Zheng, X (2015). TensorFlow: large-scale machine learning on heterogenous systems. Software available from tensorflow.org.

  • Alptekin K, Akvardar Y, Kivircik Akdede BB, Dumlu K, Işik D, Pirinçci F, Yahssin S, Kitiş A (2005). Is quality of life associated with cognitive impairment in schizophrenia? Prog Neuro-Psychopharmacol Biol Psychiatry 29(2):239–244. Epub 2004 Dec 23. PubMed PMID: 15694230.

  • Anderson G, Berk M, Dodd S, Bechter K, Altamura AC, Dell'osso B, Kanba S, Monji A, Fatemi SH, Buckley P, Debnath M, Das UN, Meyer U, Müller N, Kanchanatawan B, Maes M (2013) Immuno-inflammatory, oxidative and nitrosative stress, and neuroprogressive pathways in the etiology, course and treatment of schizophrenia. Prog Neuro-Psychopharmacol Biol Psychiatry 42:1–4. https://doi.org/10.1016/j.pnpbp.2012.10.008. Epub 2012 Oct 18. PubMed PMID: 23085074.

  • Anderson G, Maes M (2013) Schizophrenia: linking prenatal infection to cytokines, the tryptophan catabolite (TRYCAT) pathway, NMDA receptor hypofunction, neurodevelopment and neuroprogression. Prog Neuropsychopharmacol Biol Psychiatry 42: 5–19. https://doi.org/10.1016/j.pnpbp.2012.06.014. Epub 2012 Jul 16. Review. PubMed PMID: 22800757.

  • Andreasen NC (1989) The scale for the assessment of negative symptoms (SANS): conceptual and theoretical foundations. Br J Psychiatry Suppl 7:49–58

    Article  Google Scholar 

  • Becker T, Leese M, Krumm S, Ruggeri M, Vázquez-Barquero JL, EPSILON Study Group (2005) Needs and quality of life among patients with schizophrenia in five European centres: what is the impact of global functioning scores? Soc Psychiatry Psychiatr Epidemiol 40(8):628–634

    Article  Google Scholar 

  • Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. Journal of the Royal Statistics Society Series b (Methodological) 57:289–300

    Article  Google Scholar 

  • Brewer WJ, Francey SM, Wood SJ, Jackson HJ, Pantelis C, Phillips LJ, Yung AR, Anderson VA, McGorry PD (2005) Memory impairments identified in people at ultra-high risk for psychosis who later develop first-episode psychosis. Am J Psychiatry 162(1): 71–78. PubMed PMID: 15625204.

  • Brinholi FF, Noto C, Maes M, Bonifácio KL, Brietzke E, Ota VK, Gadelha A, Cordeiro Q, Belangero SI, Bressan RA, Vargas HO, Higachi L, de Farias CC, Moreira EG, Barbosa DS (2015) Lowered paraoxonase 1 (PON1) activity is associated with increased cytokine levels in drug naïve first episode psychosis. Schizophr Res 166(1–3):225–230. https://doi.org/10.1016/j.schres.2015.06.009. Epub 2015 Jun 27. PubMed PMID: 26123170.

  • Bobes J, Garcia-Portilla MP, Bascaran MT, Saiz PA, Bousoño M (2007) Quality of life in schizophrenic patients. Dialogues Clin Neurosci 9(2):215–226. Review.PubMed PMID: 17726919; PubMed Central PMCID: PMC3181847.

  • Cardoso CS, Caiaffa WT, Bandeira M, Siqueira AL, Abreu MN, Fonseca JO (2005) Factors associated with low quality of life in schizophrenia. Cad Saude Publica 21(5): 1338–1340. Epub 2005 Sep 12. PubMed PMID: 16158138.

  • Cepeda-carrion GA, Nitzl C, Roldan JL (2018) Mediation analyses in partial least squares structural equation modeling: guidelines and empirical examples. Chapter 9. Partial least squares structural equation modeling: basic concepts, methodological issues and applications, editors: Latan H, Noonan R. Springer, Heidelberg, pp 173–195. https://doi.org/10.1007/978-3-319-64069-3_8

  • CERAD (1986) CERAD – An Overview: The Consortium to Establish a Registry for Alzheimer’s Disease. http://cerad.mc.duke.edu/

  • Chollet F (2015) Keras. Software available at https://github.com/fchollet/keras.

  • Choo CC, Chew PKH, Ho CS, Ho RC (2017) Prediction of quality of life in Asian patients with schizophrenia: a cross-sectional pilot study. Front Psychiatry 8:198. https://doi.org/10.3389/fpsyt.2017.00198. eCollection 2017. PubMed PMID: 29051741; PubMed Central PMCID: PMC5634161.

  • Corlett PR, Murray GK, Honey GD, Aitken MR, Shanks DR, Robbins TW, Bullmore ET, Dickinson A, Fletcher PC (2007) Disrupted prediction-error signal in psychosis: evidence for an associative account of delusions. Brain 130(Pt 9):2387–2400. Epub 2007 Aug 9. PubMed PMID: 17690132; PubMed Central PMCID: PMC3838942

  • Davis J, Moylan S, Harvey BH, Maes M, Berk M (2014) Neuroprogression in schizophrenia: pathways underpinning clinical staging and therapeutic corollaries. Aust N Z J Psychiatry 48(6):512–529. https://doi.org/10.1177/0004867414533012. Epub 2014 May 6. Review. PubMed PMID: 24803587.

  • Davis J, Eyre H, Jacka FN, Dodd S, Dean O, McEwen S, Debnath M, McGrath J, Maes M, Amminger P, McGorry PD, Pantelis C, Berk M (2016) A review of vulnerability and risks for schizophrenia: beyond the two hit hypothesis. Neurosci Biobehav Rev 65:185–194. https://doi.org/10.1016/j.neubiorev.2016.03.017. Epub 2016 Apr 9. Review. PubMed PMID: 27073049; PubMed Central PMCID: PMC4876729.

  • Falk Hvidberg M, Brinth LS, Olesen AV, Petersen KD, Ehlers L (2015) The health-related quality of life for patients with Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS). PLoS One 10(7):e0132421. https://doi.org/10.1371/journal.pone.0132421. eCollection 2015. PubMed PMID: 26147503; PubMed Central PMCID: PMC4492975.

  • Fitzgerald PB, Williams CL, Corteling N, Filia SL, Brewer K, Adams A, de Castella AR, Rolfe T, Davey P, Kulkarni J (2001) Subject and observer-rated quality of life in schizophrenia. Acta Psychiatr Scand 103(5):387–392

    Article  CAS  Google Scholar 

  • Frith CD, Blakemore S, Wolpert DM (2000) Explaining the symptoms of schizophrenia: abnormalities in the awareness of action. Brain Res Brain Res Rev 31(2–3):357–363

    Article  CAS  Google Scholar 

  • Galuppi A, Turola MC, Nanni MG, Mazzoni P, Grassi L (2010) Schizophrenia and quality of life: how important are symptoms and functioning? Int J Ment Health Syst 4:31. https://doi.org/10.1186/1752-4458-4-31

    Article  PubMed  PubMed Central  Google Scholar 

  • Górna K, Jaracz K, Jaracz J, Kiejda J, Grabowska-Fudala B, Rybakowski J (2014) [Social functioning and quality of life in schizophrenia patients --relationship with symptomatic remission and duration of illness]. Psychiatr Pol 48(2):277–288. Polish. PubMed PMID: 25016765.

  • Häfner H (2003) Gender differences in schizophrenia. Psychoneuroendocrinology 2:17–54

    Article  Google Scholar 

  • Hamilton M (1959) The assessment of anxiety states by rating. Br J Med Psychol 32:50–55

    Article  CAS  Google Scholar 

  • Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62

    Article  CAS  Google Scholar 

  • Harvey PD, Koren D, Reihenberg A, Bowie CR (2006) Negative symptoms and cognitive deficits: what is the nature of their relationship? Schizophr Bull 32:250–258

    Article  Google Scholar 

  • Hawkins KA, Addington J, Keefe RS, Christensen B, Perkins DO, Zipurksy R, Woods SW, Miller TJ, Marquez E, Breier A, McGlashan TH (2004) Neuropsychological status of subjects at high risk for a first episode of psychosis. Schizophr Res 67(2–3):115–122. PubMed PMID: 14984870.

  • Kanchanatawan B, Hemrungrojn S, Thika S, Sirivichayakul S, Ruxrungtham K, Carvalho AF, Geffard M, Anderson G, Maes M (2018a) Changes in Tryptophan Catabolite (TRYCAT) Pathway Patterning Are Associated with Mild Impairments in Declarative Memory in Schizophrenia and Deficits in Semantic and Episodic Memory Coupled with Increased False-Memory Creation in Deficit Schizophrenia. Mol Neurobiol https://doi.org/10.1007/s12035-017-0751-8. [Epub ahead of print] PubMed PMID: 28875464.

  • Kanchanatawan B, Sirivichayakul S, Ruxrungtham K, Carvalho AF, Geffard M, Anderson G, Maes M (2018b) Deficit schizophrenia is characterized by defects in IgM-mediated responses to tryptophan catabolites (TRYCATs): a paradigm shift towards defects in natural self-regulatory immune responses coupled with mucosa-derived TRYCAT pathway activation. Mol Neurobiol 55(3):2214–2226. https://doi.org/10.1007/s12035-017-0465-y. Epub 2017 Mar 14. PubMed PMID: 28290151

  • Kanchanatawan B, Sirivichayakul S, Ruxrungtham K, Carvalho AF, Geffard M, Ormstad H, Anderson G, Maes M (2018c) Deficit, but not nondeficit, schizophrenia is characterized by mucosa-associated activation of the tryptophan catabolite (TRYCAT) pathway with highly specific increases in IgA responses directed to Picolinic, Xanthurenic, and Quinolinic acid. Mol Neurobiol 55(2):1524–1536. https://doi.org/10.1007/s12035-017-0417-6. Epub 2017 Feb 8. PubMed PMID: 28181189

  • Kanchanatawan B, Sriswasdi S, Thika S, Sirivichayakul S, Carvalho AF, Geffard M, Kubera M., Maes M (2018d) Deficit schizophrenia is a discrete diagnostic category defined by neuro-immune and neurocognitive features: results of supervised Mach Learn Metab Brain Dis https://doi.org/10.1007/s11011-018-0208-4.[Epub ahead of print] PubMed PMID: 29527624.

  • Kanchanatawan, B, Thika S, Sirivichayakul S, Carvalho AF, Geffard M, Maes M (2018e) In schizophrenia, depression, anxiety, and Physiosomatic symptoms are strongly related to psychotic symptoms and excitation, impairments in episodic memory, and increased production of neurotoxic tryptophan catabolites: a multivariate and machine learning study. Neurotox Res 33(3):641–655. https://doi.org/10.1007/s12640-018-9868-4. Epub 2018 Jan 29. PubMed PMID: 29380275.

  • Kay SR, Fiszbein A, Opler LA (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 13:261–276

    Article  CAS  Google Scholar 

  • Keefe RS, Harvey PD (2012) Cognitive impairment in schizophrenia. Handb Exp Pharmacol 213:11–37

    Article  CAS  Google Scholar 

  • Kirkpatrick B, Buchanan RW, McKenney PD, Alphs LD, Carpenter WT Jr (1989) The schedule for the deficit syndrome: an instrument for research in schizophrenia. Psychiatry Res 30:119–123

    Article  CAS  Google Scholar 

  • Kita T, Morrison PF, Heyes MP, Markey SP (2002) Effects of systemic and central nervous system localized inflammation on the contributions of metabolic precursors to the L-kynurenine and quinolinic acid pools in brain. J Neurochem 82(2):258–268

    Article  CAS  Google Scholar 

  • Kitikidou K, lliadis L (2012) Developing neural networks to investigate relationships between air quality and quality of life indicators, Air pollution - monitoring, modelling and health, Dr. Mukesh Khare (Ed.), ISBN: 978-953-51-0424-7, InTech, Available from: http://www.intechopen.com/books/air-pollution­monitoring-modelling-and-health/developing-neural-networks-to-investigate-relationships-between-air-quality­and-quality-of-life-indi

  • Kittirathanapaiboon P, Khamwongpin M (2005) The validity of the mini international neuropsychiatric interview (M.I.N.I.) Thai version: Suanprung hospital, department of Mental Health, 125–131.

  • Lang T, Rettenmeier M (2017) Understanding Consumer Behavior with Recurrent Neural Networks https://pdfs.semanticscholar.org/36f8/3b69154ccf37261d86959b80ecb404e08b3f.pdf

  • Leung A, Chue P (2000) Sex differences in schizophrenia. a review of the literature Acta Psychiatr Scand Suppl 401:3–38

    Article  CAS  Google Scholar 

  • Lobo V, Patil A, Phatak A, Chandra N (2010) Free radicals, antioxidants and functional foods: impact on human health. Pharmacogn Rev 4(8):118–126

    Article  CAS  Google Scholar 

  • Lowry PB, Gaskin J (2014) Partial least squares (PLS) structural equation modeling (SEM) for building and testing behavioral causal theory: when to choose it and how to use it. IEEE Transactions on Prof Comm 57(2):123–146

    Article  Google Scholar 

  • Maes M, Meltzer HY, Bosmans E (1994) Immune-inflammatory markers in schizophrenia: comparison to normal controls and effects of clozapine. Acta Psychiatr Scand 89(5):346–351. PubMed PMID: 8067274.

  • Maes M, Meltzer HY, Buckley P, Bosmans E (1995b) Plasma-soluble interleukin-2 and transferrin receptor in schizophrenia and major depression. Eur Arch Psychiatry Clin Neurosci 244(6):325–329. PubMed PMID: 7772617.

  • Maes M, Bosmans E, Calabrese J, Smith R, Meltzer HY (1995a) Interleukin-2 and interleukin-6 in schizophrenia and mania: effects of neuroleptics and mood stabilizers. J Psychiatr Res 29(2):141–152. PubMed PMID: 7666381.

  • Maes M, Landucci Bonifacio K, Vargas HO, Barbosa DS, Carvalho AF, Vargas Nunes SO (2018) Major differences in neuro-oxidative and neuro-nitrosative stress pathways between major depressive disorder and types I and II bipolar disorders. Mol Neurobiol 2018, in press.

  • Maitra S, Yan J (2008) Principle Component Analysis and Partial Least Squares: Two Dimension Reduction Techniques for Regression. Casuality Actuarial Society, Discussion paper. As retrieved May 6, 2018. https://www.casact.org/pubs/dpp/dpp08/08dpp76.pdf

  • McGurk SR, Mueser KT (2003) Cognitive functioning and employment in severe mental illness. J Nerv Ment Dis 191(12):789–798. PubMed PMID: 14671455.

  • Mohamed S, Rosenheck R, Swartz M, Stroup S, Lieberman JA, Keefe RS (2008) Relationship of cognition and psychopathology to functional impairment in schizophrenia. Am J Psychiatry 165(8):978–987. https://doi.org/10.1176/appi.ajp.2008.07111713. Epub 2008 May 1. PubMed PMID: 18450928.

  • Moylan S, Eyre HA, Maes M, Baune BT, Jacka FN, Berk M (2013) Exercising the worry away: how inflammation, oxidative and nitrogen stress mediates the beneficial effect of physical activity on anxiety disorder symptoms and behaviours. Neurosci Biobehav Rev 37(4):573–584

    Article  CAS  Google Scholar 

  • Myhre SR (2015) False memories in depression: vulnerability factor or symptom? Thesis, North Dakota State University of Agriculture and Applied Science Fargo, North Dakota

  • Norman RM, Malla AK, McLean T, Voruganti LP, Cortese L, McIntosh E, Cheng S, Rickwood A (2000) The relationship of symptoms and level of functioning in schizophrenia to general wellbeing and the quality of life scale. Acta Psychiatr Scand 102(4):303–309

    Article  CAS  Google Scholar 

  • Noto C, Ota VK, Santoro ML, Gouvea ES, Silva PN, Spindola LM, Cordeiro Q, Bressan RA, Gadelha A, Brietzke E, Belangero SI, Maes M (2016) Depression, cytokine, and cytokine by treatment interactions modulate gene expression in antipsychotic Naïve first episode psychosis. Mol Neurobiol 53(8):5701–5709. https://doi.org/10.1007/s12035-015-9489-3. Epub 2015 Oct 22. PubMed PMID: 26491028.

  • Noto C, Maes M, Ota VK, Teixeira AL, Bressan RA, Gadelha A, Brietzke E (2015a) High predictive value of immune-inflammatory biomarkers for schizophrenia diagnosis and association with treatment resistance. World J Biol Psychiatry 27:1–8. [Epub ahead of print] PubMed PMID: 26212792.

  • Noto C, Ota VK, Gadelha A, Noto MN, Barbosa DS, Bonifácio KL, Nunes SO, Cordeiro Q, Belangero SI, Bressan RA, Maes M, Brietzke E (2015b) Oxidative stress in drug naïve first episode psychosis and antioxidant effects of risperidone. J Psychiatr Res 68, 210–216. https://doi.org/10.1016/j.jpsychires.2015.07.003. Epub 2015 Jul 3. PubMed PMID: 26228421.

  • Orellana G, Slachevsky A (2013) Executive functioning in schizophrenia. Front Psychiatry. 4:35

    Article  Google Scholar 

  • Overall JE, Gorham DR (1962) The brief psychiatric rating scale. Psycholog Rep 10:799–812

    Article  Google Scholar 

  • Richards M, Sacker A (2003) Lifetime antecedents of cognitive reserve. J Clin Exp Neuropsychol 25(5):614–624

    Article  Google Scholar 

  • Ringle CM, da Silva D, Bido D (2014) Structural equation modeling with the SmartPLS. Brazilian Journal of Marketing - BJM Revista Brasileira de Marketing – ReMark Edição Especial 13(2)

  • Ringle CM, Wende S, Becker J-M (2015) SmartPLS 3. Bönningstedt: SmartPLS. Retrieved from http://www.smartpls.com. Accessed 19 Nov 2018

  • Ritsner M, Kurs, R, Gibel A, Ratner Y, Endicott J (2005) Validity of an abbreviated quality of life enjoyment and satisfaction questionnaire (Q-LES-Q-18) for schizophrenia, schizoaffective, and mood disorder patients. Qual Life Res 14(7):1693–1703. PubMed PMID: 16119181.

  • Savill M, Orfanos S, Reininghaus U, Wykes T, Bentall R, Priebe S (2016) The relationship between experiential deficits of negative symptoms and subjective quality of life in schizophrenia. Schizophr Res 176(2–3):387–391

    Article  CAS  Google Scholar 

  • Schweitzer R, Kelly B, Foran A, Terry D, Whiting J (1995) Quality of life in chronic fatigue syndrome. Soc Sci Med 41(10):1367–1372. PubMed PMID: 8560304

  • Sim K, Mahendran R, Siris SG, Heckers S, Chong SA (2004) Subjective quality of life in first episode schizophrenia spectrum disorders with comorbid depression. Psychiatry Res 129(2):141–147. PubMed PMID: 15590041.

  • Sirivichayakul S, Kanchanatawan B, Thika S, Carvalho AF, Maes M. (2018) Eotaxin, an endogenous cognitive deteriorating chemokine (ECDC), is a major contributor to cognitive decline in Normal people and to executive, memory, and sustained attention deficits, formal thought disorders, and psychopathology in schizophrenia patients. Neurotox Res. https://doi.org/10.1007/s12640-018-9937-8. [Epub ahead of print] PubMed PMID: 30056534.

  • Sum MY, Tay KH, Sengupta S, Sim K (2018) Neurocognitive functioning and quality of life in patients with and without deficit syndrome of schizophrenia. Psychiatry Res 263:54–60

    Article  Google Scholar 

  • Smith RS, Maes M (1995) The macrophage-T-lymphocyte theory of schizophrenia: additional evidence. Med Hypotheses 45(2):135–141. PubMed PMID: 8531836.

  • Tamminga CA, Buchanan RW, Gold JM (1998) The role of negative symptoms and cognitive dysfunction in schizophrenia outcome. Int Clin Psychopharmacol 13:s21–s26

    Article  Google Scholar 

  • Tobias RD (1995) An introduction to partial least squares regression. SAS, Data Analysis Papers SUGI Proceedings. As retrieved, 5 May, 2018. https://stats.idre.ucla.edu/wp-content/uploads/2016/02/pls.pdf

  • Tolman AW, Kurtz MM (2012) Neurocognitive predictors of objective and subjective quality of life in individuals with schizophrenia: a meta-analytic investigation. Schizophr Bull 38(2):304–315. https://doi.org/10.1093/schbul/sbq077. Epub 2010 Jul 11. PubMed PMID: 20624752; PubMed Central PMCID: PMC3283161.

  • Ueoka Y, Tomotake M, Tanaka T, Kaneda Y, Taniguchi K, Nakataki M, Numata S, Tayoshi S, Yamauchi K, Sumitani S, Ohmori T, Ueno S, Ohmori T (2011) Quality of life and cognitive dysfunction in people with schizophrenia. Prog Neuro-Psychopharmacol Biol Psychiatry 35(1):53–59. https://doi.org/10.1016/j.pnpbp.2010.08.018

    Article  Google Scholar 

  • Van Heck GL, De Vries J (2011) Quality of life of patients with chronic fatigue syndrome. Journal of Chronic Fatigue Syndrome 10(1):17–35. https://doi.org/10.1300/J092v10n01_03

    Article  Google Scholar 

  • Welsh KA, Butters N, Mohs RC, Beekly D, Edland S, Fillenbaum G, Heyman A (1994) The consortium to establish a registry for Alzheimer's disease (CERAD). Part V. a normative study of the neuropsychological battery. Neurology 44(4):609–614

    Article  CAS  Google Scholar 

  • WHO (1993) Study protocol for the World Health Organization project to develop a quality of life assessment instrument (WHOQOL). Qual Life Res 2(2):153–159

    Article  Google Scholar 

  • Zachrisson O, Regland B, Jahreskog M, Kron M, Gottfries CG (2002) A rating scale for fibromyalgia and chronic fatigue syndrome (the FibroFatigue scale). J Psychosom Res 52:501–509

    Article  Google Scholar 

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Contributors

MM and BK designed the study. BK recruited patients and completed diagnostic interviews and rating scales measurements. MM and SS carried out statistical analyses. BK, MM and SS contributed to interpretation of the data and writing of the manuscript.

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This research has been supported by the Asahi Glass Foundation, Chulalongkorn University Centenary Academic Development Project.

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Authors and Affiliations

  1. Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Pathum Wan, Bangkok, 10330, Thailand

    Buranee Kanchanatawan & Michael Maes

  2. Computational Molecular Biology Group, Chulalongkorn University, Pathum Wan, Bangkok, 10330, Thailand

    Sira Sriswasdi

  3. Research Affairs, Faculty of Medicine, Chulalongkorn University, Pathum Wan, Bangkok, 10330, Thailand

    Sira Sriswasdi

  4. Department of Psychiatry, Medical University of Plovdiv, 4000, Plovdiv, Bulgaria

    Michael Maes

  5. IMPACT Strategic Research Center, Barwon Health, Deakin University, PO Box 281, Geelong, Vic, 3220, Australia

    Michael Maes

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  1. Buranee Kanchanatawan
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Kanchanatawan, B., Sriswasdi, S. & Maes, M. Supervised machine learning to decipher the complex associations between neuro-immune biomarkers and quality of life in schizophrenia. Metab Brain Dis 34, 267–282 (2019). https://doi.org/10.1007/s11011-018-0339-7

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