{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:47:33Z","timestamp":1792597653542,"version":"4.5.0"},"reference-count":76,"publisher":"American Medical Association (AMA)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"abstract":"\n Importance<\/jats:title>\n Early identification of patients at high risk of relapse is key to personalized preventive strategies in major depressive disorder (MDD). However, current predictive models do not adequately account for the multimodal factors contributing to MDD relapse and fail to provide clinically meaningful predictions.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To predict relapse within 2 years in patients with MDD by using a comprehensive machine learning pipeline that integrates an unprecedented set of multimodal data.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This naturalistic longitudinal prognostic study used data from the Marburg-M\u00fcnster Affective Disorders Cohort Study, with baseline assessments collected from October 2014 to May 2019 and follow-up approximately 2 years later, between October 2016 and June 2021. Data analysis was conducted between July 2024 and June 2026. The study was performed at 2 sites in Germany (Marburg and M\u00fcnster), with participants recruited from psychiatric inpatient and outpatient departments and the general population. Patients meeting diagnostic criteria for current or lifetime MDD without history of neurological or severe somatic conditions were included.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Natural course of illness in patients with MDD.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Balanced accuracy (BACC) for binary prediction of relapse vs no relapse during 2-year follow-up served as the primary outcome. Baseline features comprised 9 modalities including clinical and psychometric data, 4 structural and functional magnetic resonance imaging modalities, genetics, neurocognition, blood markers, and gut microbiome.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 564 patients with a current or lifetime MDD diagnosis were included (367 female [65.1%]; mean [SD] age, 37.34 [13.38] years). A total of 270 patients relapsed during the 2-year follow-up, while 294 did not. Mean (SD) BACC for the prediction of relapse ranged from 47.21% (5.85%) to 64.43% (6.63%). The best-performing model was solely based on few clinical relapse risk factors, while multimodal data integration did not improve performance.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this prognostic study, the models achieved moderate accuracy, yet the results suggest limited scope for guiding individual-level clinical decision-making. Predictive performance was largely driven by established clinical risk factors, indicating limited incremental value of multimodal measures when assessed at a single time point. Future advances may instead benefit from dynamic modeling approaches that more closely align temporally evolving multimodal markers with longitudinal clinical outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2026.3232","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:00:28Z","timestamp":1792594828000},"source":"Crossref","is-referenced-by-count":0,"title":["Multimodal Machine Learning\u2013Based Prediction of Relapse in Major Depressive Disorder"],"prefix":"10.1001","author":[{"given":"Lea","family":"Teutenberg","sequence":"first","affiliation":[{"name":"Philipps-Universit\u00e4t Marburg, School of Medicine, Department of Psychiatry and Psychotherapy, Marburg, Germany"},{"name":"Philipps-Universit\u00e4t Marburg, Center for Mind, Brain, and Behavior, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils R.","family":"Winter","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"},{"name":"Institute for Machine Learning in Medicine With Focus Area Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Usemann","sequence":"additional","affiliation":[{"name":"Philipps-Universit\u00e4t Marburg, School of Medicine, Department of Psychiatry and Psychotherapy, Marburg, Germany"},{"name":"Philipps-Universit\u00e4t Marburg, Center for Mind, Brain, and Behavior, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederike","family":"Stein","sequence":"additional","affiliation":[{"name":"Philipps-Universit\u00e4t Marburg, School of Medicine, Department of Psychiatry and Psychotherapy, Marburg, Germany"},{"name":"Philipps-Universit\u00e4t Marburg, Center for Mind, Brain, and Behavior, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Thomas-Odenthal","sequence":"additional","affiliation":[{"name":"Philipps-Universit\u00e4t Marburg, School of Medicine, Department of Psychiatry and Psychotherapy, Marburg, Germany"},{"name":"Philipps-Universit\u00e4t Marburg, Center for Mind, Brain, and Behavior, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kira","family":"Flinkenfl\u00fcgel","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiana","family":"Borgers","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Meinert","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"},{"name":"Institute for Translational Neuroscience, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth J.","family":"Leehr","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"},{"name":"Department of Clinical Psychology and Psychotherapy, University of G\u00f6ttingen, G\u00f6ttingen, Germany"},{"name":"Philipps-Universit\u00e4t Marburg, Department of Clinical Psychology and Psychotherapy, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Grotegerd","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Papenbrock","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Teckentrup","sequence":"additional","affiliation":[{"name":"Protestant Hospital of the Bethel Foundation, Department of Psychiatry, Bielefeld University, Medical School and University Medical Center OWL, Bielefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Hildebrand","sequence":"additional","affiliation":[{"name":"Protestant Hospital of the Bethel Foundation, Department of Psychiatry, Bielefeld University, Medical School and University Medical Center OWL, Bielefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Wellms","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"},{"name":"Institute for Machine Learning in Medicine With Focus Area Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keyvan","family":"Mahjoory","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"},{"name":"Institute for Machine Learning in Medicine With Focus Area Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Konowski","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"},{"name":"Institute for Machine Learning in Medicine With Focus Area Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Spanagel","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"},{"name":"Institute for Machine Learning in Medicine With Focus Area Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon","family":"Fehse","sequence":"additional","affiliation":[{"name":"Institute of Medical Informatics, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Heider","sequence":"additional","affiliation":[{"name":"Institute of Medical Informatics, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till F. M.","family":"Andlauer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friederike S.","family":"David","sequence":"additional","affiliation":[{"name":"Philipps-Universit\u00e4t Marburg, School of Medicine, Department of Psychiatry and Psychotherapy, Marburg, Germany"},{"name":"Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas J.","family":"Forstner","sequence":"additional","affiliation":[{"name":"Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany"},{"name":"Institute of Neuroscience and Medicine, Research Center J\u00fclich, J\u00fclich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Sch\u00f6ppner","sequence":"additional","affiliation":[{"name":"Philipps-Universit\u00e4t Marburg, School of Medicine, Comprehensive Biobank Marburg, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Renz","sequence":"additional","affiliation":[{"name":"Philipps-Universit\u00e4t Marburg, Institute of Laboratory Medicine, University Hospitals Giessen and Marburg GmbH, Marburg, Germany"},{"name":"German Center for Lung Research and Lung Center of the Universities of Giessen and Marburg, Marburg, Germany"},{"name":"Kilimanjaro Christian Medical University, Moshi, Tanzania"},{"name":"Tongji Medical School, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna","family":"Bang","sequence":"additional","affiliation":[{"name":"Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Franke","sequence":"additional","affiliation":[{"name":"Institute of Clinical Molecular Biology, Christian-Albrechts-University Kiel and University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie H.","family":"Witt","sequence":"additional","affiliation":[{"name":"Center for Mental Health, Partner Site Mannheim-Heidelberg-Ulm, Mannheim, Germany"},{"name":"Biobank of the Center for Innovative Psychiatric and Psychotherapeutic Research, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany"},{"name":"Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcella","family":"Rietschel","sequence":"additional","affiliation":[{"name":"Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Streit","sequence":"additional","affiliation":[{"name":"Center for Mental Health, Partner Site Mannheim-Heidelberg-Ulm, Mannheim, Germany"},{"name":"Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany"},{"name":"Hector Institute for Artificial Intelligence in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Alexander","sequence":"additional","affiliation":[{"name":"Philipps-Universit\u00e4t Marburg, School of Medicine, Department of Psychiatry and Psychotherapy, Marburg, Germany"},{"name":"Philipps-Universit\u00e4t Marburg, Center for Mind, Brain, and Behavior, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Jansen","sequence":"additional","affiliation":[{"name":"Philipps-Universit\u00e4t Marburg, School of Medicine, Department of Psychiatry and Psychotherapy, Marburg, Germany"},{"name":"Philipps-Universit\u00e4t Marburg, Center for Mind, Brain, and Behavior, Marburg, Germany"},{"name":"Philipps-Universit\u00e4t Marburg, School of Medicine, Core-Facility BrainImaging, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Nenadi\u0107","sequence":"additional","affiliation":[{"name":"Philipps-Universit\u00e4t Marburg, School of Medicine, Department of Psychiatry and Psychotherapy, Marburg, Germany"},{"name":"Philipps-Universit\u00e4t Marburg, Center for Mind, Brain, and Behavior, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Straube","sequence":"additional","affiliation":[{"name":"Philipps-Universit\u00e4t Marburg, School of Medicine, Department of Psychiatry and Psychotherapy, Marburg, Germany"},{"name":"Philipps-Universit\u00e4t Marburg, Center for Mind, Brain, and Behavior, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamidreza","family":"Jamalabadi","sequence":"additional","affiliation":[{"name":"Philipps-Universit\u00e4t Marburg, School of Medicine, Department of Psychiatry and Psychotherapy, Marburg, Germany"},{"name":"Philipps-Universit\u00e4t Marburg, Center for Mind, Brain, and Behavior, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udo","family":"Dannlowski","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"},{"name":"Protestant Hospital of the Bethel Foundation, Department of Psychiatry, Bielefeld University, Medical School and University Medical Center OWL, Bielefeld, Germany"},{"name":"German Center for Mental Health, Site Jena Magdeburg Halle, Jena, Germany"},{"name":"Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health, Site Jena Magdeburg Halle, Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Hahn","sequence":"additional","affiliation":[{"name":"Institute for Translational Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"},{"name":"Institute for Machine Learning in Medicine With Focus Area Psychiatry, University of M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilo","family":"Kircher","sequence":"additional","affiliation":[{"name":"Philipps-Universit\u00e4t Marburg, School of Medicine, Department of Psychiatry and Psychotherapy, Marburg, Germany"},{"name":"Philipps-Universit\u00e4t Marburg, Center for Mind, Brain, and Behavior, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"issue":"4","key":"yoi260049r1","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1037\/a0025190","article-title":"Recurrence in major depression: a conceptual analysis.","volume":"118","author":"Monroe","year":"2011","journal-title":"Psychol Rev"},{"issue":"9904","key":"yoi260049r2","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1016\/S0140-6736(13)61611-6","article-title":"Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010.","volume":"382","author":"Whiteford","year":"2013","journal-title":"Lancet"},{"issue":"1","key":"yoi260049r3","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1080\/21556660.2019.1612410","article-title":"Economic burden of relapse\/recurrence in patients with major depressive disorder.","volume":"8","author":"Gauthier","year":"2019","journal-title":"J Drug Assess"},{"key":"yoi260049r4","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.cpr.2018.07.005","article-title":"Risk factors for relapse and recurrence of depression in adults and how they operate: a four-phase systematic review and meta-synthesis.","volume":"64","author":"Buckman","year":"2018","journal-title":"Clin Psychol Rev"},{"issue":"9","key":"yoi260049r5","doi-asserted-by":"publisher","first-page":"3671","DOI":"10.1038\/s41380-023-02298-3","article-title":"An umbrella review of candidate predictors of response, remission, recovery, and relapse across mental disorders.","volume":"28","author":"Solmi","year":"2023","journal-title":"Mol Psychiatry"},{"issue":"2","key":"yoi260049r6","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1176\/appi.ajp.2011.11020335","article-title":"Childhood maltreatment predicts unfavorable course of illness and treatment outcome in depression: a meta-analysis.","volume":"169","author":"Nanni","year":"2012","journal-title":"Am J Psychiatry"},{"issue":"5","key":"yoi260049r7","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1001\/jamapsychiatry.2018.0123","article-title":"Association of brain cortical changes with relapse in patients with major depressive disorder.","volume":"75","author":"Zaremba","year":"2018","journal-title":"JAMA Psychiatry"},{"issue":"4","key":"yoi260049r8","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1016\/S0006-3223(02)01474-9","article-title":"Larger amygdala volumes in first depressive episode as compared to recurrent major depression and healthy control subjects.","volume":"53","author":"Frodl","year":"2003","journal-title":"Biol Psychiatry"},{"issue":"4","key":"yoi260049r9","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1016\/j.biopsych.2011.03.009","article-title":"Mood-linked responses in medial prefrontal cortex predict relapse in patients with recurrent unipolar depression.","volume":"70","author":"Farb","year":"2011","journal-title":"Biol Psychiatry"},{"issue":"11","key":"yoi260049r10","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1089\/jwh.2017.6878","article-title":"Predictors of depressive relapse in women undergoing infertility treatment.","volume":"27","author":"Freeman","year":"2018","journal-title":"J Womens Health (Larchmt)"},{"issue":"7","key":"yoi260049r11","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1001\/jamapsychiatry.2021.0701","article-title":"Polygenic liability and recurrence of depression in patients with first-onset depression treated in hospital-based settings.","volume":"78","author":"Musliner","year":"2021","journal-title":"JAMA Psychiatry"},{"issue":"9","key":"yoi260049r12","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1001\/jamapsychiatry.2022.1780","article-title":"Quantifying deviations of brain structure and function in major depressive disorder across neuroimaging modalities.","volume":"79","author":"Winter","year":"2022","journal-title":"JAMA Psychiatry"},{"issue":"2","key":"yoi260049r13","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1038\/s41380-019-0585-z","article-title":"Prospective biomarkers of major depressive disorder: a systematic review and meta-analysis.","volume":"25","author":"Kennis","year":"2020","journal-title":"Mol Psychiatry"},{"issue":"1","key":"yoi260049r14","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1146\/annurev-clinpsy-032816-045037","article-title":"Machine learning approaches for clinical psychology and psychiatry.","volume":"14","author":"Dwyer","year":"2018","journal-title":"Annu Rev Clin Psychol"},{"issue":"1","key":"yoi260049r15","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1038\/mp.2016.201","article-title":"Predictive analytics in mental health: applications, guidelines, challenges and perspectives.","volume":"22","author":"Hahn","year":"2017","journal-title":"Mol Psychiatry"},{"issue":"2","key":"yoi260049r16","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1002\/wps.20882","article-title":"The promise of machine learning in predicting treatment outcomes in psychiatry.","volume":"20","author":"Chekroud","year":"2021","journal-title":"World Psychiatry"},{"key":"yoi260049r17","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1016\/j.jad.2025.01.060","article-title":"Machine learning-based prediction of illness course in major depression: the relevance of risk factors.","volume":"374","author":"Teutenberg","year":"2025","journal-title":"J Affect Disord"},{"issue":"03","key":"yoi260049r18","doi-asserted-by":"publisher","first-page":"145","DOI":"10.3389\/fpsyt.2019.00145","article-title":"Emotional biases and recurrence in major depressive disorder: results of 2.5 years follow-up of drug-free cohort vulnerable for recurrence.","volume":"10","author":"Ruhe","year":"2019","journal-title":"Front Psychiatry"},{"issue":"1","key":"yoi260049r19","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1038\/s41398-019-0615-2","article-title":"Predicting rehospitalization within 2 years of initial patient admission for a major depressive episode: a multimodal machine learning approach.","volume":"9","author":"Cearns","year":"2019","journal-title":"Transl Psychiatry"},{"issue":"12","key":"yoi260049r20","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1016\/j.biopsych.2023.05.024","article-title":"Multimodal data integration advances longitudinal prediction of the naturalistic course of depression and reveals a multimodal signature of remission during 2-year follow-up.","volume":"94","author":"Habets","year":"2023","journal-title":"Biol Psychiatry"},{"issue":"1","key":"yoi260049r21","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1038\/s41398-018-0289-1","article-title":"Predicting the naturalistic course of depression from a wide range of clinical, psychological, and biological data: a machine learning approach.","volume":"8","author":"Dinga","year":"2018","journal-title":"Transl Psychiatry"},{"issue":"4","key":"yoi260049r22","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1016\/j.biopsych.2014.11.018","article-title":"Predicting the naturalistic course of major depressive disorder using clinical and multimodal neuroimaging information: a multivariate pattern recognition study.","volume":"78","author":"Schmaal","year":"2015","journal-title":"Biol Psychiatry"},{"issue":"2","key":"yoi260049r23","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1192\/bjp.2021.218","article-title":"Predicting relapse or recurrence of depression: systematic review of prognostic models.","volume":"221","author":"Moriarty","year":"2022","journal-title":"Br J Psychiatry"},{"issue":"1","key":"yoi260049r24","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/1758-2946-6-10","article-title":"Cross-validation pitfalls when selecting and assessing regression and classification models.","volume":"6","author":"Krstajic","year":"2014","journal-title":"J Cheminform"},{"issue":"4","key":"yoi260049r25","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1001\/jamapsychiatry.2023.5083","article-title":"A systematic evaluation of machine learning-based biomarkers for major depressive disorder.","volume":"81","author":"Winter","year":"2024","journal-title":"JAMA Psychiatry"},{"issue":"8","key":"yoi260049r26","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1007\/s00406-018-0943-x","article-title":"Neurobiology of the major psychoses: a translational perspective on brain structure and function\u2014the FOR2107 consortium.","volume":"269","author":"Kircher","year":"2019","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"key":"yoi260049r27","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1016\/j.neuroimage.2018.01.079","article-title":"The Marburg-M\u00fcnster Affective Disorders Cohort Study (MACS): a quality assurance protocol for MR neuroimaging data.","volume":"172","author":"Vogelbacher","year":"2018","journal-title":"Neuroimage"},{"issue":"7","key":"yoi260049r29","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1176\/ajp.145.7.844","article-title":"Graphic representation of the life course of illness in patients with affective disorder.","volume":"145","author":"Post","year":"1988","journal-title":"Am J Psychiatry"},{"issue":"7","key":"yoi260049r31","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-048008","article-title":"Protocol for development of a reporting guideline (TRIPOD-AI) and risk of bias tool (PROBAST-AI) for diagnostic and prognostic prediction model studies based on artificial intelligence.","volume":"11","author":"Collins","year":"2021","journal-title":"BMJ Open"},{"issue":"11","key":"yoi260049r32","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1055\/s-0030-1247564","article-title":"The German version of the Childhood Trauma Questionnaire (CTQ): preliminary psychometric properties.","volume":"60","author":"Wingenfeld","year":"2010","journal-title":"Psychother Psychosom Med Psychol"},{"issue":"1","key":"yoi260049r33","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1136\/jnnp.23.1.56","article-title":"A rating scale for depression.","volume":"23","author":"Hamilton","year":"1960","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"6","key":"yoi260049r34","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1001\/archpsyc.1961.01710120031004","article-title":"An inventory for measuring depression.","volume":"4","author":"Beck","year":"1961","journal-title":"Arch Gen Psychiatry"},{"issue":"1","key":"yoi260049r35","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1111\/j.2044-8341.1959.tb00467.x","article-title":"The assessment of anxiety states by rating.","volume":"32","author":"Hamilton","year":"1959","journal-title":"Br J Med Psychol"},{"issue":"2","key":"yoi260049r38","first-page":"165","article-title":"Development and psychometric evaluation of the Resilience Scale.","volume":"1","author":"Wagnild","year":"1993","journal-title":"J Nurs Meas"},{"issue":"1","key":"yoi260049r39","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.2044-8341.1979.tb02487.x","article-title":"A parental bonding instrument.","volume":"52","author":"Parker","year":"1979","journal-title":"Br J Med Psychol"},{"issue":"5","key":"yoi260049r40","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1111\/j.1600-0404.1995.tb07018.x","article-title":"Multiple choice vocabulary test MWT as a valid and short test to estimate premorbid intelligence.","volume":"91","author":"Lehrl","year":"1995","journal-title":"Acta Neurol Scand"},{"issue":"5","key":"yoi260049r44","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1192\/bjp.133.5.429","article-title":"A rating scale for mania: reliability, validity and sensitivity.","volume":"133","author":"Young","year":"1978","journal-title":"Br J Psychiatry"},{"issue":"9","key":"yoi260049r45","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1055\/s-2007-995279","article-title":"German version of the Snaith-Hamilton-Pleasure Scale (SHAPS-D): anhedonia in schizophrenic and depressive patients.","volume":"66","author":"Franz","year":"1998","journal-title":"Fortschr Neurol Psychiatr"},{"issue":"3","key":"yoi260049r46","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1007\/s001030050034","article-title":"Erfassung der gesundheitsbezogenen Lebensqualit\u00e4t mit dem SF-36-Health Survey.","volume":"43","author":"Bullinger","year":"2000","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"issue":"4","key":"yoi260049r47","doi-asserted-by":"publisher","first-page":"385","DOI":"10.2307\/2136404","article-title":"A global measure of perceived stress.","volume":"24","author":"Cohen","year":"1983","journal-title":"J Health Soc Behav"},{"issue":"4","key":"yoi260049r48","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1521\/pedi.1995.9.4.346","article-title":"The SPQ-B: a brief screening instrument for schizotypal personality disorder.","volume":"9","author":"Raine","year":"1995","journal-title":"J Pers Disord"},{"issue":"1","key":"yoi260049r51","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1002\/nur.4770070110","article-title":"Modification of life event questionnaires for use with female respondents.","volume":"7","author":"Norbeck","year":"1984","journal-title":"Res Nurs Health"},{"issue":"5580","key":"yoi260049r52","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1126\/science.1071829","article-title":"Serotonin transporter genetic variation and the response of the human amygdala.","volume":"297","author":"Hariri","year":"2002","journal-title":"Science"},{"issue":"3","key":"yoi260049r53","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1016\/j.cell.2024.12.002","article-title":"Trans-ancestry genome-wide study of depression identifies 697 associations implicating cell types and pharmacotherapies.","volume":"188","author":"Adams","year":"2025","journal-title":"Cell"},{"issue":"5","key":"yoi260049r54","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1038\/s41588-019-0397-8","article-title":"Genome-wide association study identifies 30 loci associated with bipolar disorder.","volume":"51","author":"Stahl","year":"2019","journal-title":"Nat Genet"},{"issue":"7906","key":"yoi260049r55","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1038\/s41586-022-04434-5","article-title":"Mapping genomic loci implicates genes and synaptic biology in schizophrenia.","volume":"604","author":"Trubetskoy","year":"2022","journal-title":"Nature"},{"issue":"9","key":"yoi260049r56","doi-asserted-by":"publisher","first-page":"1540","DOI":"10.1038\/s41590-023-01588-w","article-title":"Genetics of circulating inflammatory proteins identifies drivers of immune-mediated disease risk and therapeutic targets.","volume":"24","author":"Zhao","year":"2023","journal-title":"Nat Immunol"},{"issue":"1","key":"yoi260049r57","doi-asserted-by":"publisher","first-page":"2198","DOI":"10.1038\/s41467-022-29650-5","article-title":"Genetic analysis of over half a million people characterises C-reactive protein loci.","volume":"13","author":"Said","year":"2022","journal-title":"Nat Commun"},{"issue":"1","key":"yoi260049r58","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1038\/s41588-017-0013-8","article-title":"Association analysis in over 329,000 individuals identifies 116 independent variants influencing neuroticism.","volume":"50","author":"Luciano","year":"2018","journal-title":"Nat Genet"},{"issue":"2","key":"yoi260049r59","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1007\/s10519-015-9735-5","article-title":"Meta-analysis of genome-wide association studies for extraversion: findings from the Genetics of Personality Consortium.","volume":"46","author":"van den Berg","year":"2016","journal-title":"Behav Genet"},{"issue":"2","key":"yoi260049r65","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1001\/archpsyc.1997.01830140071013","article-title":"Auditory working memory and Wisconsin Card Sorting Test performance in schizophrenia.","volume":"54","author":"Gold","year":"1997","journal-title":"Arch Gen Psychiatry"},{"issue":"9","key":"yoi260049r67","doi-asserted-by":"publisher","first-page":"1841","DOI":"10.1038\/sj.npp.1301131","article-title":"Report by the ACNP Task Force on response and remission in major depressive disorder.","volume":"31","author":"Rush","year":"2006","journal-title":"Neuropsychopharmacology"},{"issue":"7","key":"yoi260049r68","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0254062","article-title":"PHOTONAI-A Python API for rapid machine learning model development.","volume":"16","author":"Leenings","year":"2021","journal-title":"PLoS One"},{"issue":"8","key":"yoi260049r70","doi-asserted-by":"publisher","first-page":"1510","DOI":"10.1038\/s41386-021-01020-7","article-title":"Systematic misestimation of machine learning performance in neuroimaging studies of depression.","volume":"46","author":"Flint","year":"2021","journal-title":"Neuropsychopharmacology"},{"issue":"3","key":"yoi260049r71","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1192\/bjp.2022.160","article-title":"Association between polypharmacy and depression relapse in individuals with comorbid depression and type 2 diabetes: a UK electronic health record study.","volume":"222","author":"Jeffery","year":"2023","journal-title":"Br J Psychiatry"},{"key":"yoi260049r72","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.psyneuen.2014.10.001","article-title":"Obesity and major depression: body-mass index (BMI) is associated with a severe course of disease and specific neurostructural alterations.","volume":"51","author":"Opel","year":"2015","journal-title":"Psychoneuroendocrinology"},{"issue":"6","key":"yoi260049r74","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1001\/jamapsychiatry.2024.0228","article-title":"A dynamical systems view of psychiatric disorders\u2014practical implications: a review.","volume":"81","author":"Scheffer","year":"2024","journal-title":"JAMA Psychiatry"},{"issue":"2","key":"yoi260049r75","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1007\/s00115-025-01886-8","article-title":"The SFB\/TRR 393 Collaborative Research Centre: trajectories of affective disorders: cognitive-emotional mechanisms of symptom change.","volume":"97","author":"Kircher","year":"2026","journal-title":"Nervenarzt"},{"issue":"2","key":"yoi260049r76","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1007\/s00115-025-01917-4","article-title":"Trajectories of affective disorders: neurobiological mechanisms during symptom change.","volume":"97","author":"Ebner-Priemer","year":"2026","journal-title":"Nervenarzt"},{"key":"yoi260049r28","volume-title":"SKID-I: Strukturiertes Klinisches Interview f\u00fcr DSM-IV","author":"Wittchen","year":"1997"},{"key":"yoi260049r30","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"2000","edition":"4th ed, text re"},{"key":"yoi260049r36","volume-title":"Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI): Professional Manual","author":"Costa","year":"1992"},{"key":"yoi260049r37","volume-title":"F-SozU: Fragebogen zur sozialen Unterst\u00fctzung","author":"Fydrich","year":"2007"},{"key":"yoi260049r41","volume-title":"Das State-Trait-Angstinventar","author":"Laux","year":"1981"},{"key":"yoi260049r42","volume-title":"The Scale for the Assessment of Negative Symptoms (SANS)","author":"Andreasen","year":"1983"},{"key":"yoi260049r43","volume-title":"The Scale for the Assessment of Positive Symptoms (SAPS)","author":"Andreasen","year":"1984"},{"key":"yoi260049r49","first-page":"320","volume-title":"St\u00f6rungsspezifische Therapieans\u00e4tze in der station\u00e4ren Psychotherapie","author":"Steffanowski","year":"2001"},{"key":"yoi260049r50","volume-title":"AUDIT: The Alcohol Use Disorders Identification Test\u2014Guidelines for Use in Primary Health Care","author":"Babor","year":"2001","edition":"2nd ed"},{"key":"yoi260049r60","volume-title":"Trail Making Test: Manual for Administration and Scoring","author":"Reitan","year":"1979"},{"key":"yoi260049r61","volume-title":"Der Aufmerksamkeits-Belastungstest d2","author":"Brickenkamp","year":"2002"},{"key":"yoi260049r62","volume-title":"RWT: Regensburger Wortfl\u00fcssigkeits-Test","author":"Aschenbrenner","year":"2000"},{"key":"yoi260049r63","volume-title":"WAIS-IV: Wechsler Adult Intelligence Scale","author":"Wechsler","year":"2008"},{"key":"yoi260049r64","volume-title":"Wechsler Memory Scale: Administration and Scoring Manual","author":"Wechsler","year":"1997"},{"key":"yoi260049r66","volume-title":"Verbaler Lern- und Merkf\u00e4higkeitstest","author":"Helmstaedter","year":"2001"},{"key":"yoi260049r69","unstructured":"Winter? N, Teutenberg? L. Machine learning-based prediction of relapse in major depressive disorder: a multimodal approach. Accessed June 19, 2026. https:\/\/github.com\/wwu-mmll\/machine_learning-based_prediction_of_relapse_in_major_depressive_disorder-a_multimodal_approach"},{"key":"yoi260049r73","doi-asserted-by":"crossref","unstructured":"Puder? LM, Winter? NR, Goltermann? J, . Predicting relapse and psychosocial functioning in major depressive disorder: a machine learning approach using clinical and resting-state fMRI data.? medRxiv. Preprint posted online October 23, 2025. doi:10.1101\/2025.10.22.25334871?","DOI":"10.1101\/2025.10.22.25334871"}],"container-title":["JAMA Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/articlepdf\/2855664\/jamapsychiatry_teutenberg_2026_oi_260049_1792072267.29946.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:00:31Z","timestamp":1792594831000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/fullarticle\/2855664"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,21]]},"references-count":76,"URL":"https:\/\/doi.org\/10.1001\/jamapsychiatry.2026.3232","relation":{},"ISSN":["2168-622X"],"issn-type":[{"value":"2168-622X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,21]]}}}