Outcome Prediction for Patients with Bipolar Disorder Using Prodromal and Onset Data

Background: Predicting the outcomes of serious mental illnesses including bipolar disorder (BD) is clinically beneficial, yet difficult. Objectives: This study aimed to predict hospitalization and mortality for patients with incident BD using a deep neural network approach. Methods: We randomly sampled 20,000 US Veterans with BD. Data on patients' prior hospitalizations, diagnoses, procedures, medications, note types, vital signs, lab results, and BD symptoms that occurred within 1 year before and at the onset of the incident BD were extracted as features. We then created novel temporal images of patient clinical features both during the prodromal period and at the time of the disease onset. Using each temporal image as a feature, we trained and tested deep neural network learning models to predict the 1-year combined outcome of hospitalization and mortality. Results: The models achieved accuracies of 0.766-0.949 and AUCs of 0.745-0.806 for the combined outcomes. The AUC for predicting mortality was 0.814, while its highest and lowest values for predicting different types of hospitalization were 90.4% and 70.1%, suggesting that some outcomes were more difficult to predict than others. Conclusion: Deep learning using temporal graphics of clinical history is a new and promising analytical approach for mental health outcome prediction.