Limited progress in the discovery of biological markers of PTSD has hampered accurate diagnosis, early identification of cases, staging and prognosis, stratification, personalized treatment, and new drug development. There is limited understanding of the biological processes underlying the core features of PTSD and associated psychiatric and somatic comorbidity. PTSD is precipitated by experiencing or witnessing actual or threatened death, serious injury, or violence, and has symptoms that include re-experiencing, avoidance, negative thoughts, or moods associated with the traumatic event and hyperarousal (DSM-5 ). veterans of the Vietnam and subsequent conflicts, including the Iraq and Afghanistan wars. Similar content being viewed by othersĬombat-related post-traumatic stress disorder (PTSD) has a lifetime prevalence of between 10.1%–30.9% in U.S. The identification and validation of this diverse diagnostic panel represents a powerful and novel approach to improve accuracy and reduce bias in diagnosing combat-related PTSD. The final diagnostic panel of 28 features was validated in an independent cohort (26 cases, 26 controls) with good performance (AUC = 0.80, 81% accuracy, 85% sensitivity, and 77% specificity). After reassessment of ~30% of these participants, we refined this set of markers from 343 to 28, based on their performance and ability to track changes in phenotype over time. ![]() These candidate biomarkers were selected from an integrated approach using (1) data-driven methods, including Support Vector Machine with Recursive Feature Elimination and other standard or published methodologies, and (2) hypothesis-driven approaches, using previous genetic studies for polygenic risk, or other PTSD-related literature. In a discovery cohort of 83 warzone-related PTSD cases and 82 warzone-exposed controls, we identified a set of 343 candidate biomarkers. In the search for PTSD diagnostic biomarkers, we ascertained over one million molecular, cellular, physiological, and clinical features from three cohorts of male veterans. Identification of these signals could aid in diagnostics, treatment decision-making, and risk evaluation. ![]() Therefore, disease signals likely span multiple biological domains, including genes, proteins, cells, tissues, and organism-level physiological changes. Prior studies suggest that PTSD may be a systemic illness, affecting not just the brain, but the entire body. Post-traumatic stress disorder (PTSD) impacts many veterans and active duty soldiers, but diagnosis can be problematic due to biases in self-disclosure of symptoms, stigma within military populations, and limitations identifying those at risk. Molecular Psychiatry volume 25, pages 3337–3349 ( 2020) Cite this article Multi-omic biomarker identification and validation for diagnosing warzone-related post-traumatic stress disorder
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