Cerebral hemodynamic characteristics of patients with auditory verbal hallucinations and the construction of nomogram models

doi:10.5498/wjp.v15.i6.106775

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World Journal of Psychiatry

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World J Psychiatry. Jun 19, 2025; 15(6): 106775
Published online Jun 19, 2025. doi: 10.5498/wjp.v15.i6.106775

Table 1 General information of patients in three groups

Variables		SCZ group (n = 117)	PTSD group (n = 108)	RDD group (n = 105)	F	P value
Age (year), mean ± SD		26.97 ± 6.15	26.28 ± 5.49	27.10 ± 5.23	0.669	0.513
Gender	Male	54	52	35	5.645	0.06
Gender	Female	63	56	70	5.645	0.06
Years of education		12.37 ± 3.32	12.49 ± 2.68	12.03 ± 2.86	0.688	0.503
BMI		23.13 ± 3.43	22.64 ± 3.00	22.94 ± 3.15	0.665	0.515
Course of disease (months)		4.81 ± 1.22	5.02 ± 1.08	4.95 ± 1.41	0.819	0.442

Table 2 Cerebral hemodynamic indices in three groups of patients, mean ± SD

Variables	SCZ group (n = 117)	PTSD group (n = 108)	RDD group (n = 105)	F	P value
Vm-MCA	57.25 ± 10.26	56.21 ± 8.15	59.36 ± 9.16^b	3.214	0.041
Vs-MCA	88.52 ± 15.03	87.25 ± 13.64	91.26 ± 13.26^b	2.260	0.106
Vd-MCA	41.05 ± 11.63	40.55 ± 10.69	44.69 ± 8.19^ab	5.143	0.006
PI-MCA	0.81 ± 0.18	0.82 ± 0.15	0.79 ± 0.21	1.255	0.287
RI-MCA	0.55 ± 0.19	0.57 ± 0.19	0.55 ± 0.15	0.777	0.461
Vm-ACA	48.75 ± 10.82	47.65 ± 9.95	44.25 ± 10.21^a^,^b	5.597	0.004
Vs-ACA	74.36 ± 12.09	73.69 ± 10.21	71.15 ± 12.95^a	2.220	0.110
Vd-ACA	31.95 ± 9.11	32.66 ± 8.81	34.21 ± 9.47	1.764	0.173
PI-ACA	0.86 ± 0.21	0.86 ± 0.22	0.79 ± 0.32	2.043	0.131
RI-ACA	0.58 ± 0.21	0.55 ± 0.14	0.59 ± 0.15	1.764	0.173
Vm-PCA	34.21 ± 7.67	37.65 ± 6.35^a	33.32 ± 5.54^b	12.843	< 0.001
Vs-PCA	51.06 ± 8.15	54.84 ± 8.69^a	50.94 ± 7.47^b	8.102	< 0.001
Vd-PCA	22.61 ± 6.95	24.36 ± 5.58	21.33 ± 5.49^b	6.699	0.001
PI-PCA	0.80 ± 0.19	0.77 ± 0.14	0.82 ± 0.15^b	2.651	0.072
RI-PCA	0.59 ± 0.18	0.63 ± 0.18	0.63 ± 0.15	1.824	0.163
Vm-BA	35.61 ± 7.64	38.21 ± 6.65^a	35.24 ± 7.19^b	5.506	0.004
Vs-BA	55.26 ± 10.62	57.95 ± 8.65^a	54.86 ± 9.16^b	3.339	0.037
Vd-BA	22.82 ± 7.19	24.69 ± 6.17^a	22.17 ± 7.71^b	3.703	0.026
PI-BA	0.81 ± 0.21	0.76 ± 0.15	0.83 ± 0.19^b	4.323	0.014
RI-BA	0.56 ± 0.12	0.52 ± 0.15	0.58 ± 0.12^b	5.605	0.004
Vm-VA	35.61 ± 7.65	38.19 ± 6.65	40.22 ± 7.49^a^,^b	11.198	< 0.001
Vs-VA	56.85 ± 12.43	58.41 ± 10.65	59.17 ± 9.33	1.313	0.270
Vd-VA	18.21 ± 7.45	24.16 ± 7.95^a	23.27 ± 6.13^a^,^b	22.261	< 0.001
PI-VA	0.78 ± 0.17	0.73 ± 0.15^a	0.73 ± 0.14^a	4.129	0.017
RI-VA	0.58 ± 0.15	0.52 ± 0.13^a	0.54 ± 0.15	3.444	0.033

^aP < 0.05, compared to schizophrenia with auditory verbal hallucinations group.

^bP < 0.05, compared to PTSD group.

SCZ group: Schizophrenia with auditory verbal hallucinations; PTSD group: Post-traumatic stress disorder with auditory verbal hallucinations; RDD group: Recurrent depressive disorder with auditory verbal hallucinations; Vm: Mean velocity; Vs: Peak systolic velocity; Vd: End-diastolic velocity; PI: Pulsatility index; RI: Resistance index; MCA: Middle cerebral artery; ACA: Anterior cerebral artery; PCA: Posterior cerebral artery; BA: Basilar artery; VA: Vertebral artery.

Table 3 Univariate and multivariate logistic regression analyses in patients with schizophrenia with auditory verbal hallucinations

Variables	Univariate logistic regression analysis					Multivariate logistic regression analysis
Variables	β	SE	Z	P value	OR (95%CI)	β	SE	Z	P value	OR (95%CI)
Vm-MCA	-0.02	0.01	-1.60	0.110	0.98 (0.95-1.01)	-	-	-	-	-
Vs-MCA	-0.01	0.01	-1.42	0.154	0.99 (0.97-1.01)	-	-	-	-	-
Vd-MCA	-0.04	0.01	-2.60	0.009	0.96 (0.94-0.99)	-0.06	0.02	-3.43	< 0.001	0.94 (0.91-0.97)
PI-MCA	0.51	0.68	0.75	0.455	1.66 (0.44-6.27)	-	-	-	-	-
RI-MCA	-0.33	0.77	-0.42	0.673	0.72 (0.16-3.27)	-	-	-	-	-
Vm-ACA	0.04	0.01	3.05	0.002	1.04 (1.01-1.07)	0.06	0.02	3.70	< 0.001	1.06 (1.03-1.10)
Vs-ACA	0.02	0.01	1.88	0.060	1.02 (1.00-1.04)	-	-	-	-	-
Vd-ACA	-0.03	0.01	-1.80	0.072	0.97 (0.95-1.00)	-	-	-	-	-
PI-ACA	0.85	0.51	1.65	0.099	2.33 (0.85-6.36)	-	-	-	-	-
RI-ACA	-0.18	0.75	-0.24	0.812	0.84 (0.19-3.65)	-	-	-	-	-
Vm-PCA	0.02	0.02	0.99	0.321	1.02 (0.98-1.06)	-	-	-	-	-
Vs-PCA	0.00	0.02	0.11	0.909	1.00 (0.97-1.04)	-	-	-	-	-
Vd-PCA	0.03	0.02	1.49	0.136	1.03 (0.99-1.08)	-	-	-	-	-
PI-PCA	-1.00	0.81	-1.24	0.214	0.37 (0.08-1.78)	-	-	-	-	-
RI-PCA	-1.53	0.85	-1.81	0.071	0.22 (0.04-1.14)	-	-	-	-	-
Vm-BA	0.01	0.02	0.36	0.717	1.01 (0.97-1.04)	-	-	-	-	-
Vs-BA	0.00	0.01	0.29	0.770	1.00 (0.98-1.03)	-	-	-	-	-
Vd-BA	0.01	0.02	0.65	0.514	1.01 (0.98-1.05)	-	-	-	-	-
PI-BA	-0.75	0.68	-1.11	0.267	0.47 (0.13-1.78)	-	-	-	-	-
RI-BA	-2.04	1.18	-1.72	0.085	0.13 (0.01-1.33)	-	-	-	-	-
Vm-VA	-0.08	0.02	-4.16	< 0.001	0.92 (0.89-0.96)	-0.11	0.02	-4.72	< 0.001	0.90 (0.86-0.94)
Vs-VA	-0.02	0.01	-1.55	0.121	0.98 (0.96-1.01)	-	-	-	-	-
Vd-VA	-0.11	0.02	-4.85	< 0.001	0.90 (0.86-0.94)	-0.13	0.03	-5.03	< 0.001	0.88 (0.84-0.93)
PI-VA	2.11	0.89	2.38	0.017	8.26 (1.45-47.10)	-	-	-	-	-
RI-VA	1.30	0.90	1.45	0.148	3.66(0.63-21.25)	-	-	-	-	-

SE: Standard error of mean; CI: Confidence interval; OR: Odds ratio; Vm: Mean velocity; Vs: Peak systolic velocity; Vd: End-diastolic velocity; PI: Pulsatility index; RI: Resistance index; MCA: Middle cerebral artery; ACA: Anterior cerebral artery; PCA: Posterior cerebral artery; BA: Basilar artery; VA: Vertebral artery.

Table 4 Confusion matrix analysis for clinical prediction model 1

AUC (95%CI)	Accuracy (95%CI)	Sensitivity (95%CI)	Specificity (95%CI)	PPV (95%CI)	NPV (95%CI)	Cut off
0.82 (0.76-0.87)	0.78 (0.72-0.83)	0.72 (0.64-0.81)	0.83 (0.76-0.90)	0.79 (0.71-0.87)	0.77 (0.70-0.84)	0.464

AUC: Area under the curve; PPV: Positive predictive value; NPV: Negative predictive value; CI: Confidence interval.

Table 5 Univariate and multivariate logistic regression analyses in patients with post-traumatic stress disorder with auditory verbal hallucinations

Variables	Univariate logistic regression analysis					Multivariate logistic regression analysis
Variables	β	SE	Z	P	OR (95%CI)	β	SE	Z	P	OR (95%CI)
Vm-MCA	-0.04	0.02	-2.59	0.010	0.96 (0.93-0.99)	-0.06	0.02	-2.74	0.006	0.95 (0.91-0.98)
Vs-MCA	-0.02	0.01	-2.14	0.033	0.98 (0.96-0.99)	-0.04	0.01	-2.75	0.006	0.96 (0.94-0.99)
Vd-MCA	-0.05	0.02	-3.05	0.002	0.96 (0.93-0.98)	-0.06	0.02	-2.71	0.007	0.95 (0.91-0.98)
PI-MCA	1.20	0.76	1.58	0.114	3.33 (0.75-14.84)	-	-	-	-	-
RI-MCA	0.66	0.79	0.83	0.404	1.93 (0.41-9.11)	-	-	-	-	-
Vm-ACA	0.03	0.01	2.41	0.016	1.03 (1.01-1.06)	0.05	0.02	2.45	0.014	1.05 (1.01-1.09)
Vs-ACA	0.02	0.01	1.57	0.115	1.02 (1.00-1.04)	-	-	-	-	-
Vd-ACA	-0.02	0.02	-1.23	0.217	0.98 (0.95-1.01)	-	-	-	-	-
PI-ACA	0.81	0.51	1.60	0.110	2.24 (0.83-6.04)	-	-	-	-	-
RI-ACA	-1.90	0.96	-1.98	0.048	0.15 (0.02-0.98)	-	-	-	-	-
Vm-PCA	0.12	0.03	4.71	< 0.001	1.13 (1.08-1.19)	0.12	0.03	3.61	< 0.001	1.13 (1.06-1.20)
Vs-PCA	0.06	0.02	3.31	< 0.001	1.06 (1.03-1.10)	0.07	0.02	2.69	0.007	1.07 (1.02-1.12)
Vd-PCA	0.10	0.03	3.73	< 0.001	1.11 (1.05-1.17)	0.13	0.04	3.54	< 0.001	1.14 (1.06-1.23)
PI-PCA	-2.55	1.01	-2.52	0.012	0.08 (0.01-0.57)	-2.77	1.38	-2.01	0.044	0.06 (0.00-0.93)
RI-PCA	-0.20	0.82	-0.24	0.810	0.82 (0.16-4.12)	-	-	-	-	-
Vm-BA	0.06	0.02	3.01	0.003	1.06 (1.02-1.11)	0.10	0.03	3.50	< 0.001	1.10 (1.04-1.17)
Vs-BA	0.04	0.02	2.46	0.014	1.04 (1.01-1.07)	0.05	0.02	2.47	0.013	1.06 (1.01-1.10)
Vd-BA	0.05	0.02	2.57	0.010	1.05 (1.01-1.10)	-	-	-	-	-
PI-BA	-2.55	0.85	-3.00	0.003	0.08 (0.01-0.41)	-	-	-	-	-
RI-BA	-3.38	1.10	-3.07	0.002	0.03 (0.00-0.30)	-4.07	1.46	-2.79	0.005	0.02 (0.00-0.30)
Vm-VA	-0.04	0.02	-2.05	0.040	0.96 (0.92-0.99)	-	-	-	-	-
Vs-VA	-0.01	0.01	-0.56	0.574	0.99 (0.97-1.02)	-	-	-	-	-
Vd-VA	0.02	0.02	0.90	0.366	1.02 (0.98-1.06)	-	-	-	-	-
PI-VA	0.04	0.95	0.05	0.964	1.04 (0.16-6.71)	-	-	-	-	-
RI-VA	-1.06	1.00	-1.06	0.291	0.35 (0.05-2.48)	-	-	-	-	-

Table 6 Confusion matrix analysis for clinical prediction model 2

AUC (95%CI)	Accuracy (95%CI)	Sensitivity (95%CI)	Specificity (95%CI)	PPV (95%CI)	NPV (95%CI)	Cut off
0.88 (0.83-0.92)	0.80 (0.75-0.89)	0.79 (0.71-0.86)	0.79 (0.71-0.87)	0.79 (0.71-0.87)	0.82 (0.74-0.89)	0.534

AUC: Area under the curve; PPV: Positive predictive value; NPV: Negative predictive value; CI: Confidence interval.

Table 7 Univariate and multivariate logistic regression analyses in patients with recurrent depressive disorder with auditory verbal hallucinations

Variables	Univariate logistic regression analysis					Multivariate logistic regression analysis
Variables	β	SE	Z	P	OR (95%CI)	β	SE	Z	P	OR (95%CI)
Vm-MCA	0.03	0.01	2.35	0.019	1.03 (1.01-1.06)	0.05	0.02	3.12	0.002	1.05 (1.02-1.08)
Vs-MCA	0.02	0.01	2.00	0.045	1.02 (1.01-1.03)	-	-	-	-	-
Vd-MCA	0.04	0.01	3.11	0.002	1.04 (1.01-1.06)	0.06	0.01	3.91	< 0.001	1.06 (1.03-1.09)
PI-MCA	-0.88	0.65	-1.36	0.174	0.41 (0.12-1.48)	-	-	-	-	-
RI-MCA	-0.13	0.65	-0.21	0.837	0.87 (0.24-3.13)	-	-	-	-	-
Vm-ACA	-0.04	0.01	-3.16	0.002	0.96 (0.94-0.99)	-0.05	0.01	-3.45	< 0.001	0.95 (0.93-0.98)
Vs-ACA	-0.02	0.01	-2.05	0.041	0.98 (0.96-0.99)	-0.03	0.01	-2.14	0.032	0.97 (0.95-0.99)
Vd-ACA	0.02	0.01	1.77	0.076	1.02 (1.00-1.05)	-	-	-	-	-
PI-ACA	-0.96	0.48	-2.00	0.045	0.38 (0.15-0.98)	-	-	-	-	-
RI-ACA	0.78	0.70	1.11	0.269	2.17 (0.55-8.59)	-	-	-	-	-
Vm-PCA	-0.06	0.02	-3.10	0.002	0.94 (0.91-0.98)	-0.06	0.02	-2.93	0.003	0.94 (0.90-0.98)
Vs-PCA	-0.03	0.01	-1.96	0.050	0.97 (0.94-0.99)	-0.04	0.02	-2.09	0.036	0.96 (0.93-0.99)
Vd-PCA	-0.06	0.02	-2.86	0.004	0.94 (0.91-0.98)	-0.07	0.02	-2.92	0.004	0.93 (0.89-0.98)
PI-PCA	1.54	0.76	2.04	0.041	4.67 (1.06-20.51)	-	-	-	-	-
RI-PCA	0.81	0.70	1.16	0.247	2.26 (0.57-8.95)	-	-	-	-	-
Vm-BA	-0.03	0.02	-1.87	0.062	0.97 (0.94-1.00)	-	-	-	-	-
Vs-BA	-0.02	0.01	-1.48	0.140	0.98 (0.96-1.01)	-	-	-	-	-
Vd-BA	-0.03	0.02	-1.84	0.066	0.97 (0.94-1.00)	-	-	-	-	-
PI-BA	1.49	0.65	2.30	0.021	4.44 (1.25-15.80)	-	-	-	-	-
RI-BA	2.65	0.97	2.74	0.006	14.10 (2.12-93.73)	3.23	1.16	2.79	0.005	25.30 (2.62-244.31)
Vm-VA	0.06	0.02	3.71	< .001	1.07 (1.03-1.10)	0.09	0.02	4.39	< 0.001	1.09 (1.05-1.13)
Vs-VA	0.01	0.01	1.22	0.223	1.01 (0.99-1.04)	-	-	-	-	-
Vd-VA	0.04	0.02	2.41	0.016	1.04 (1.01-1.07)	0.07	0.02	3.61	< 0.001	1.07 (1.03-1.11)
PI-VA	-1.15	0.78	-1.48	0.140	0.32 (0.07-1.46)	-	-	-	-	-
RI-VA	-0.28	0.82	-0.35	0.729	0.75 (0.15-3.74)	-	-	-	-	-

Table 8 Confusion matrix analysis for clinical prediction model 3

AUC (95%CI)	Accuracy (95%CI)	Sensitivity (95%CI)	Specificity (95%CI)	PPV (95%CI)	NPV (95%CI)	Cut off
0.81 (0.77-0.86)	0.75 (0.70-0.80)	0.74 (0.68-0.80)	0.78 (0.70-0.86)	0.88 (0.83-0.92)	0.58 (0.50-0.66)	0.314

AUC: Area under the curve; PPV: Positive predictive value; NPV: Negative predictive value; CI: Confidence interval.

Citation: Cai ZY, Chen C, Huang ZY, Ye XW, Jin XZ, Chen HR, Sha JM. Cerebral hemodynamic characteristics of patients with auditory verbal hallucinations and the construction of nomogram models. World J Psychiatry 2025; 15(6): 106775
URL: https://www.wjgnet.com/2220-3206/full/v15/i6/106775.htm
DOI: https://dx.doi.org/10.5498/wjp.v15.i6.106775