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        Unsupervised Machine Learning to Identify Depressive Subtypes

        Benson Kung,Maurice Chiang,Gayan Perera,Megan Pritchard,Robert Stewart 대한의료정보학회 2022 Healthcare Informatics Research Vol.28 No.3

        Objectives: This study evaluated an unsupervised machine learning method, latent Dirichlet allocation (LDA), as a methodfor identifying subtypes of depression within symptom data. Methods: Data from 18,314 depressed patients were used to createLDA models. The outcomes included future emergency presentations, crisis events, and behavioral problems. One modelwas chosen for further analysis based upon its potential as a clinically meaningful construct. The associations between patientgroups created with the final LDA model and outcomes were tested. These steps were repeated with a commonly-usedlatent variable model to provide additional context to the LDA results. Results: Five subtypes were identified using the finalLDA model. Prior to the outcome analysis, the subtypes were labeled based upon the symptom distributions they produced:psychotic, severe, mild, agitated, and anergic-apathetic. The patient groups largely aligned with the outcome data. For example,the psychotic and severe subgroups were more likely to have emergency presentations (odds ratio [OR] = 1.29; 95% confidenceinterval [CI], 1.17–1.43 and OR = 1.16; 95% CI, 1.05–1.29, respectively), whereas these outcomes were less likely inthe mild subgroup (OR = 0.86; 95% CI, 0.78–0.94). We found that the LDA subtypes were characterized by clusters of uniquesymptoms. This contrasted with the latent variable model subtypes, which were largely stratified by severity. Conclusions:This study suggests that LDA can surface clinically meaningful, qualitative subtypes. Future work could be incorporated intostudies concerning the biological bases of depression, thereby contributing to the development of new psychiatric therapeutics.

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