Correction: A multimodal approach to depression diagnosis: insights from machine learning algorithm development in primary care

Abstract

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Correction to: European Archives of Psychiatry and Clinical Neuroscience 10.1007/s00406-025-01990-5

In the article several values published in the text and tables have been corrected to ensure accuracy.

In the “Methods and Design” section, the percentage of participants has been revised from two decimal places to one. The sentence now reads: “Of the remaining 581 participants, 28.4% were recruited at the LMU site, and 71.6% came from various GP offices,” instead of “28.40%” and “71.60%” respectively.

In the “Results” section, The ‘n’ value for outpatient individuals has been corrected to n = 491 from n = 481. The number of participants in the entire cohort who reported having sought professional psychiatric or psychological help has been corrected to n = 271, replacing the previously stated n = 109, which erroneously referred to admissions to psychiatric units or day clinics. The percentage of participants who reported currently taking psychiatric medication has been revised to 16.5% instead of 16.3%.

Additionally, test statistics have been corrected for completeness by including the degrees of freedom. The notation (H = 10.99, p = 0.01, η^2^ = 0.11) now reads (H(3) = 10.99, p = 0.01, η^2^ = 0.11), and (H = 13.42, p < 0.01, η^2^ = 0.134) has been corrected to (H(3) = 13.42, p < 0.01, η^2^ = 0.13).

In the Discussion section, sensitivity and specificity changed to 93.2% and 93.3% instead of 93%.

In addition to the above textual changes, the values and descriptions within the tables have been modified. The corrected Tables 1, 3 and 4 are provided below.

Table 1. Descriptive statistics and group comparisons for depressed and non-depressed groupsVariableNon-depressed (N = 491)M (SD)Depressed (N = 90) M (SD)p valueAge (years)43.47 (14.68)40.34 (13.10)0.052Sex (%, female)60.1%68.9%0.14Binge drinking (%, yes)60.2%50.0%0.15Depressive episode before recent episode (%, yes)10.6%71.1% < 0.001Currently taking psychiatric medication (%, yes)8.4%59.6% < 0.001Number of depressive episodes over lifetime0.30 (1.39)5.90 (9.79) < 0.001Total body weight (kg)73.58 (17.48)72.67 (17.29)0.53Total muscle mass (kg)52.26 (10.60)49.57 (9.55)0.04Total body water (kg)37.17 (8.26)35.29 (7.42)0.06Body mass index (BMI, kg/m^2^)24.42 (4.91)24.49 (5.05)0.76Body fat percentage (%)24.39 (7.67)26.50 (8.57)0.06Visceral fat score5.73 (4.64)5.29 (4.35)0.35Basal metabolic rate (BMR, kcal)1631.55 (324.97)1670.96 (706.66)0.23Waist-to-hip ratio0.85 (0.10)0.83 (0.10)0.29Waist circumference (cm)81.70 (14.60)81.10 (14.23)0.97Hip circumference (cm)96.47 (11.14)98.66 (13.63)0.15Body temperature (°C)36.43 (0.44)36.51 (0.45)0.07Resting heart rate (bpm)70.78 (12.45)75.79 (13.48) < 0.001Diastolic blood pressure (mmHg)80.47 (10.41)81.87 (10.25)0.13Systolic blood pressure (mmHg)124.96 (17.39)124.70 (17.14)0.96Heart rate (bpm), lying position68.05 (9.81)69.55 (9.79)0.13HRV (SDNN, ms), lying position45.53 ( 24.56)39.64 (20.16)0.10HRV (RMSSD, ms), lying position43.17 ( 31.01)37.76 (24.30)0.26HRV (LF, ms^2^), lying position1351.14 (1452.71)990.16 (1022.93)0.02HRV (HF, ms^2^), lying position972.55 (1380.75)799.09 (1077.74)0.36HRV (Baevskii index), lying position170.95 (247.96)224.24 (271.75)0.03Glucose level (mg/dL)75.41 (14.06)80.06 (17.60)0.001**CRP (mg/dL)0.23 (0.70)0.28 (0.51)0.29AST (U/L)23.97 (7.76)22.99 (8.73)0.10ALT (U/L)23.36 (13.08)23.50 (12.48)0.89Gamma-GT (U/L)20.86 (19.87)22.14 (27.16)0.88Total cholesterol (mg/dL)192.32 (40.60)201.01 (42.93)0.09Triglycerides (mg/dL)93.71 (52.77)108.19 ( 57.55)0.02LDL-cholesterol (mg/dL)114.64 (34.68)122.36 ( 38.52)0.10HDL-cholesterol (mg/dL)61.76 (15.87)61.78 (13.81)0.73Non-HDL cholesterol (mg/L)132.53 (39.82)135.22 (44.39)0.85HbA1c (NGSP, %)5.29 (0.53)5.29 (0.46)0.53Leukocyte count (10⁹/L)5.49 (1.50)6.15 (1.79)0.002Erythrocyte count (10^12^/L)4.72 ( 0.44)4.71 ( 0.39)0.83Hemoglobin (g/dL)14.01 (1.59)13.98 (1.33)0.66Hematocrit (%)41.35 (3.48)41.19 (3.35)0.70Platelet count (10^9^/L)251.03 (62.11)271.39 (68.66)0.02Neutrophil count (10^9^/L)3.09 (1.14)3.55 (1.26) < 0.001Monocyte count (10^9^/L)0.43 (0.13)0.48 (0.17)0.03Eosinophil count (10^9^/L)0.16 (0.15)0.17 (0.17)0.92Basophil count (10^9^/L)0.04 (0.02)0.05 (0.02)0.02Normoblast count (10^9^/L)0.10 (0.00)0.10 (0.02)0.35Lymphocyte count (10^9^/L)1.75 (0.54)1.88 (0.59)0.07Monocyte count (10^9^/L)0.43 (0.13)0.48 (0.17)0.03TSH (µU/mL)2.03 (1.43)1.93 (1.04)0.90Cortisol (µg/dL)13.88 (7.03)14.07 (6.67)0.71IGF-1 (ng/mL)163.31 (59.65)160.87 (56.05)0.83Alpha-1-antitrypsin (g/L)1.36 (0.22)1.41 ( 0.22)0.049MADRS score4.72 (4.93)22.30 (8.03) < 0.001WHODAS 2.0 score7.46 (8.09)24.01 (10.05) < 0.001WHO-5 score18.15 (4.84)11.23 (4.11) < 0.001PHQ-9 score4.77 (3.51)14.68 (5.18) < 0.001UCLA 3-items score5.27 (1.78)7.69 (2.34) < 0.001PC-PTSD score0.57 (1.10)1.98 (1.84) < 0.001Lubben social network scale14.35 (4.75)13.58 (6.80) < 0.02GAD-7 score4.20 (3.74)11.59 (5.21) < 0.001PHQ-15 score5.82 (3.84)11.64 (5.34) < 0.001Number of siblings1.30 ( 0.86)1.39 (0.94)0.40Adults in household1.93 (0.74)1.88 (0.93)0.17Partner from another ethnicity (%, yes)21.9%18.5%0.70Separation in the last 12 months (%, yes)6.7%15.9%0.01Sport ≥ 1 × per week (%, yes)77.2%54.4% < 0.001Heart attack (%, yes)5.9%3.4%0.49Employment in the last 12 months (%, yes)86.2%82.8%0.49Biological children (%, yes)44.1%34.1%0.10Migration background (%, yes)23.4%25.8%0.72Caring for relatives (%, yes)9.3%4.6%0.21Moved during childhood/adolescence (%, yes)60.0%68.2%0.19Born in Germany (%, yes)87.0%89.3%0.69Mother tongue German (%, yes)90.1%90.5%0.99Parents separated (%, yes)26.1%44.9% < 0.001Attempted suicide (%, yes)2.5%20.2% < 0.001****p < 0.05, **p < 0.01, *p < 0.001 MADRS: Montgomery–Åsberg Depression Rating Scale, measuring the severity of depressive symptomsWHODAS 2.0 Score World Health Organization Disability Assessment Schedule 2.0 12-item score, WHO-5 Score World Health Organization-5 Well-Being Index, PHQ-9 Score Patient Health Questionnaire-9, UCLA 3-items Score UCLA Loneliness Scale, 3-item version, PC-PTSD Score Primary Care PTSD Screen, GAD-7 Generalized Anxiety Disorder 7-item, PHQ-15 Score: Patient Health Questionnaire 15, IGF-1 Insulin-like Growth Factor 1, CRP C-reactive protein, TSH thyroid stimulating hormone, AST aspartate aminotransferase, ALT alanine aminotransferase, LDL low-density lipoprotein, HDL high-density lipoprotein cholesterol, gamma-GT gamma-glutamyl transferase

Table 3. The performance of sequential model depicting the traffic light system and the probabilities of correct and incorrect disease classificationModel nameTotalHigh certainty groupsLow certainty groupsRed traffic lightGreen traffic lightYellow traffic lightDepressionHCDepressionHCDepressionHCClinical 5 (first step)76/90 (84.4%)424/491 (86.4%)38/45 (84.4%)219/235 (93.2%)38/45 (84.4%)205/256 (80.1%)Clinical 15 (second step) 79/90 (87.8%)

436/491 (88.8%)

55/59 (93.2%)

320/343 (93.3%) 24/31 (77.4%)116/148 (78.4%)The table shows the number of correctly classified instances versus the total number of true instances for both classes in the clinical sequential systemHC healthy control

Table 4. Shows descriptive statistics as well as group comparisons of clusters that were found through GMMLate depression, n = 27, M (SD)Adaptive, n = 26, M (SD)Overweight non-inflammatory, n = 28, M (SD)Immuno-metabolic, n = 9, M (SD)p valueAge at study Inclusion (years)50.76 (10.85)33.20 (9.97)35.39 (11.05)45.27 (11.77) < 0.001Sex (%, female)88.980.842.955.60.001Binge drinking (%, yes)18.549.565.852.40.001Depressive episode before recent episode (%, yes)70.469.282.144.40.20Currently Taking Psychiatric Medication (%, yes)70.440.764.366.70.12Number of depressive episodes over lifetime4.23 (4.11)4.23 (3.47)5.30 (8.87)9.63 (15.32)0.35Total body weight (kg)67.76 (9.45)62.41 (8.01)80.33 (12.89)94.91 (28.89) < 0.001Total muscle mass (kg)44.31 (5.22)46.05 (5.95)55.86 (8.42)57.44 (11.93) < 0.001Total body water (kg)31.48 (3.38)31.89 (3.94)40.19 (6.15)42.42 (10.52) < 0.001Body mass index (BMI, kg/m^2^)24.01 (3.30)21.57 (2.37)25.38 (3.92)31.51 (8.45) < 0.001Body fat percentage (%)28.70 (7.58)22.07 (5.14)26.14 (8.60)33.84 (9.92) < 0.001Visceral fat score5.55 (2.67)2.13 (1.32)6.06 (3.26)11.83 (6.97) < 0.001Basal metabolic rate (BMR, kcal)1416.54 (151.19)1773.23 (1158.59)1739.16 (246.26)1843.06 (416.04) < 0.001Waist-to-hip ratio0.82 (0.08)0.82 (0.08)0.84 (0.08)0.84 (0.23)0.08Waist circumference (cm)82.05 (10.26)72.27 (6.50)85.29 (9.97)92.51 (30.41) < 0.001Hip circumference (cm)100.79 (9.11)88.62 (8.81)101.50 (9.26)112.68 (24.68) < 0.001Body temperature (°C)36.65 (0.47)36.53 (0.43)36.43 (0.45)36.30 (0.45)0.15Resting heart rate (bpm)71.67 (8.95)72.77 (12.97)77.93 (12.67)90.22 (18.89)0.01Diastolic blood pressure (mmHg)84.07 (10.08)75.38 (9.10)81.89 (7.22)93.89 (9.36) < 0.001Systolic blood pressure (mmHg)130.15 (21.21)113.04 (11.55)125.89 (13.05)138.33 (7.71) < 0.001Heart rate (bpm), lying position69.33 (6.85)67.83 (9.74)68.17 (8.14)77.18 (7.87)0.03HRV (SDNN, ms), lying position31.30 (9.74)51.78 (19.67)43.88 (13.29)20.11 (9.46) < 0.001HRV (RMSSD, ms), lying position30.41 (14.01)51.15 (25.03)41.66 (16.90)15.97 (9.53) < 0.001HRV (LF, ms^2^), Lying position544.88 (352.27)1527.11 (1134.72)1148.59 (764.74)295.95 (224.47) < 0.001HRV (HF, ms^2^), Lying position435.02 (465.31)1358.87 (1288.45)895.79 (780.96)149.45 (187.31) < 0.001HRV (Baevskii Index), lying position238.47 (117.39)117.61 (79.17)148.28 (85.20)596.62 (549.83) < 0.001Glucose level (mg/dL)77.37 (10.53)75.38 (8.47)82.39 (12.78)93.33 (43.88)0.07CRP (mg/dL)0.15 (0.10)0.20 (0.47)0.36 (0.69)0.62 (0.54) < 0.001AST (U/L)23.60 (6.54)20.19 (3.48)21.57 (6.02)33.56 (19.25)0.001ALT (U/L)23.86 (9.84)15.92 (4.67)24.54 (8.84)40.89 (22.75) < 0.001Gamma-GT (U/L)19.42 (10.74)11.77 (4.35)21.25 (8.79)61.67 (72.12) < 0.001Total cholesterol (mg/dL)218.84 (44.05)175.77 (29.08)196.43 (36.00)233.89 (47.83) < 0.001Triglycerides (mg/dL)106.10 (35.63)71.12 (25.77)116.57 (60.13)197.56 (62.67) < 0.001LDL cholesterol (mg/dL)134.39 (39.60)95.35 (23.79)124.71 (33.77)155.56 (36.32) < 0.001HDL cholesterol (mg/dL)66.93 (10.71)69.96 (10.96)53.46 (11.60)47.89 (10.45) < 0.001Non-HDL cholesterol (mg/dL)142.14 (34.27)107.14 (23.73)140.08 (38.96)181.63 (41.48) < 0.001HbA1c (NGSP, %)5.34 (0.32)5.17 (0.29)5.26 (0.38)5.59 (1.03)0.48Leukocyte count (10^9^/L)5.54 (1.26)5.16 (1.20)7.05 (1.79)7.92 (1.95) < 0.001Erythrocyte Count (10^12^/L)4.58 (0.35)4.54 (0.33)4.99 (0.30)4.74 (0.43) < 0.001Hemoglobin (g/dL)13.79 (1.16)13.12 (1.11)14.74 (0.97)14.61 (1.73) < 0.001Hematocrit (%)40.81 (3.27)38.93 (2.75)43.12 (2.45)42.64 (3.40) < 0.001Platelet count (10^9^/L)267.89 (69.64)249.61 (60.43)275.11 (59.05)329.56 (84.23)0.02Neutrophils (%)57.18 (8.70)55.02 (9.79)58.86 (7.06)57.22 (8.61)0.44Neutrophil count (10^9^/L)3.19 (0.92)2.88 (0.98)4.18 (1.29)4.49 (1.24) < 0.001Eosinophil count (10^9^/L)0.14 (0.08)0.15 (0.12)0.18 (0.23)0.30 (0.22)0.13Basophil count (10^9^/L)0.05 (0.03)0.04 (0.02)0.05 (0.03)0.07 (0.02)0.02Normoblast count (10^9^/L)0.11 (0.04)0.10 (0.00)0.10 (0.00)0.10 (0.00)0.85Lymphocyte count (10^9^/L)1.74 (0.56)1.64 (0.46)2.06 (0.51)2.35 (0.83)0.002Monocyte count (10^9^/L)0.40 (0.10)0.43 (0.13)0.54 (0.17)0.66 (0.25) < 0.001Red cell distribution width (RDW, CV, %)12.83 (0.87)13.1 (0.87)12.43 (0.54)12.96 (0.88)0.02Platelet distribution width (PDW, %)13.17 (2.11)14.08 (2.30)12.61 (1.93)13.00 (1.58)0.10Mean platelet volume (MPV, fL)10.92 (0.96)11.33 (1.00)10.68 (0.93)10.73 (0.86)0.08Thyroid-stimulating hormone (TSH, µU/mL)1.38 (0.71)1.85 (0.93)2.39 (1.18)2.38 (0.91) < 0.01Cortisol (µg/dL)12.11 (3.27)15.66 (8.32)13.45 (5.07)12.94 (4.83)0.58IGF-1119.86 (33.59)184.92 (52.92)190.46 (50.14)119.64 (34.61) < 0.001Alpha-1-antitrypsin (g/l)1.38 (0.16)1.44 (0.28)1.38 (0.22)1.45 (0.15)0.42MADRS score20.70 (8.37)21.85 ( 6.26)22.32 (7.06)28.33 (12.20)0.10WHODAS 2.0 score21.50 (8.78)23.15 (9.70)25.59 (8.86)25.24 (8.43)0.37WHO-5 score11.22 (4.30)11.97 (4.67)11.04 (3.62)10.03 (2.54)0.77PHQ-9 score14.68 (5.49)13.73 (5.24)14.98 (4.99)15.94 (2.63)0.67UCLA 3-items score6.93 (2.30)7.77 (1.27)8.64 (2.90)6.78 (2.05)0.02Lubben social network scale14.33 (6.39)12.42 (6.68)13.43 (5.96)15.56 (10.34)0.64GAD-7 score11.25 (5.57)11.34 (5.15)11.18 (4.84)15.00 (4.50)0.25PHQ-15 score11.76 (5.23)11.84 (4.88)10.45 (4.20)14.33 (7.84)0.27Number of siblings1.30 (0.90)1.32 (0.93)1.47 (0.96)1.56 (0.88)0.83Adults in household1.93 (0.78)1.76 (0.76)1.89 (1.07)2.00 (1.12)0.91Education level (1–3)2.67 (0.62)2.69 (0.55)2.64 (0.62)2.33 (0.71)0.40Low education7.4%3.9%7.1%11.1%Medium education18.5%23.1%21.4%44.4%High education74.1%73.1%71.4%44.4%Partner from another ethnicity (%, yes)14.3%23.1%21.9%7.9%0.17Separation in last 12 months (%, yes)12.2%15.4%25.0%0.0%0.37Sport ≥ 1 × per week (%, yes)59.3%65.4%50.0%22.2%0.15Heart attack (%, yes)3.7%0.0%3.6%11.1%0.35Employment in last 12 months (%, yes)77.3%84.6%96.4%55.6%0.02Biological children (%)56.6%15.4%33.2%22.2%0.01*Migration background (%, yes)29.6%30.8%21.4%11.1%0.65Caring for relatives (%, yes)3.7%7.7%4.1%0.0%0.79Moved during childhood/adolescence (%, yes)63.5%76.9%71.4%44.4%0.27Born in Germany (%, yes)84.7%91.8%88.8%100.0%0.55Mother tongue German (%, yes)84.7%91.2%92.4%98.4%0.80Parents separated (%, yes)34.4%57.7%46.4%33.3%0.36Attempted suicide (%, yes)25.9%19.2%10.7%33.3%0.34Financial difficulties in last 12 months (0–2)0.22 (0.58)0.50 (0.81)0.80 (0.91)1.25 (0.93)0.002Never85.1%69.2%50.0%22.2%Once7.4%11.5%14.3%11.1%Multiple times7.4%19.2%32.1%55.6%p < 0.05, **p < 0.01, only significant findings that were not part of the GMM clustering process are marked with a star ()MADRS Montgomery–Åsberg Depression Rating Scale, measuring the severity of depressive symptoms, WHODAS 2.0 Score World Health Organization Disability Assessment Schedule 2.0, WHO-5 Score World Health Organization-5 Well-Being Index, PHQ-9 Score Patient Health Questionnaire-9, UCLA 3-items Score UCLA Loneliness Scale, 3-item version, PC-PTSD Score: Primary Care PTSD Screen, GAD-7 Generalized Anxiety Disorder 7-item, PHQ-15 Score Patient Health Questionnaire 15, IGF-1 Insulin-like Growth Factor 1, CRP C-reactive protein, TSH thyroid stimulating hormone, AST aspartate aminotransferase, ALT alanine aminotransferase, LDL low-density lipoprotein, HDL high-density lipoprotein cholesterol, gamma-GT gamma-glutamyl transferase

The original article has been corrected.