Psychiatry

Comprehensive Summary

This study determines whether 9 machine learning (ML) models can reliably predict depression risk based on polyfluoroalkyl substance (PFAS) exposure using National Health and Nutrition Examination Survey (NHANES) data. PFAS are synthetic chemicals frequently present in commercial products. Researchers utilized data from seven NHANES cycles between 2005-2018, and analyzed 9,074 adults with both PFAS panels and depression screening using PHQ-9, with a score of 10 or higher being the classification for depression, along with covariates like age, gender, race, and education levels being accounted for. Researchers identified 7 different PFAS by online SPE-HPLC-TIS-MS/MS (a type of spectrometry), and trained nine different ML models, evaluating their performance based on receiver operating characteristic curve (ROC), AUC, accuracy, sensitivity, specificity, and interpretability using partial dependence analysis and SHAP; depression risk prediction web calculator was developed with Gradio framework and statistical analyses were performed. CatBoost performed the best with an AUC of 0.75 with 73% accuracy), and CatBoost ranked poverty-to-income ratio (PIR), age, smoke, BMI, marital status, and perfluorooctane sulfonic acid (PFOS), among the top contributors to depression. PFOS was the most highly ranked PFAS. Partial dependence plots (PDPs) indicated a threshold effect for PFOS at 11.66 ng/mL; beyond this threshold, higher PFOS were associated with reduced depression risk contributions. This study demonstrates the possibilities of an ML framework linking PFAS profiles, especially PFOS, to depression risk patterns.

Outcomes and Implications

ML has been used in medicine to build disease-risk models from exposure data. For example, the Extreme Gradient Boosting ML model has been developed to investigate the relationship between depression and certain blood values, discovering an association between depression and blood heavy metals like cadmium, ethyl, and mercury. The insights, specifically risk analysis, that CatBoost and other ML models can provide on PFAS-related depression risk is invaluable to future research and public health policy. PFAS exposure is widespread and persistent; if specific exposure indicators help predict elevated depression risk, clinicians and public health teams could better target screening and prevention in vulnerable communities. Interpretable ML can help make environmental risk more visible to medical practitioners and policymakers. However, researchers emphasize that the findings are correlational since there are unmodeled survey weighting and limited environmental co-exposures, and there should be future research conducted on external validation, broader range of environmental exposures, and studies should limit confounding biases and computational constraints.

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© 2025 AIIM. Created by AIIM IT Team