Depression is one of the world's leading mental disorders and has a range of negative consequences for the individual and society. Despite being such a major and widespread problem, its diagnosis is still problematic and inadequate, suggesting the need for standardised and more reliable ways of diagnosing depression. The identification of biomarkers represents a diagnostic tool with a greater degree of objectivity, which would help improve current practice, that relies on self-report and clinical interviews. In this thesis, we propose different
levels of gut microbiome function as targets for biomarker discovery. The latter represents a complex system that influences host physiology, metabolism, immunity, nutrition and behaviour - mechanisms that have been shown to be disrupted in depression. Accordingly, we obtained 157 sequenced faecal samples, 87 from depressed patients and 70 from healthy individuals, as well as their metadata (age, sex, body mass index, gastrointestinal transit time, quality of life parameters) (LifeLines Project). The data were preprocessed using the bioBakery
platform and analysed in two software programmes - Orange and JADBio. In both, we identified a subset of biomarkers that were most relevant in predicting depression. Among these, enzymes accounted for the largest proportion, followed by metabolic pathways and taxa, as well as gene families in JADBio. The selected characteristics were the basis for teaching classification models to diagnose depression in unknown samples. In both programmes, we obtained a near-perfect model in discriminating between healthy individuals and patients with depression - in Orange it was a model based on a Naive Bayes algorithm (AUC 0.949), and in
JADBio it was a Ridge logistic regression model (AUC 0.967). We have thus shown that the gut microbiome can indeed be a suitable target to search for biomarkers of depression and that, based on the identified biomarkers, we can build a model that discriminates with high accuracy between healthy individuals and patients with depression, which has a huge potential to solve the problems clinicians face when diagnosing depression, especially in relation to other diseases that can be easily detected via the microbiome.
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