The contribution of depressive ‘disorder characteristics’ to determinations of prognosis for adults with depression: an individual patient data meta-analysis
dc.contributor.author | Buckman, JEJ | |
dc.contributor.author | Saunders, R | |
dc.contributor.author | Cohen, ZD | |
dc.contributor.author | Barnett, P | |
dc.contributor.author | Clarke, K | |
dc.contributor.author | Ambler, G | |
dc.contributor.author | DeRubeis, RJ | |
dc.contributor.author | Gilbody, S | |
dc.contributor.author | Hollon, SD | |
dc.contributor.author | Kendrick, T | |
dc.contributor.author | Watkins, E | |
dc.contributor.author | Wiles, N | |
dc.contributor.author | Kessler, D | |
dc.contributor.author | Richards, D | |
dc.contributor.author | Sharp, D | |
dc.contributor.author | Brabyn, S | |
dc.contributor.author | Littlewood, E | |
dc.contributor.author | Salisbury, C | |
dc.contributor.author | White, IR | |
dc.contributor.author | Lewis, G | |
dc.contributor.author | Pilling, S | |
dc.date.accessioned | 2021-04-14T12:12:03Z | |
dc.date.issued | 2021-04-14 | |
dc.description.abstract | Background This study aimed to investigate general factors associated with prognosis regardless of the type of treatment received, for adults with depression in primary care. Methods We searched Medline, Embase, PsycINFO and Cochrane Central (inception to 12/01/2020) for RCTs that included the most commonly used comprehensive measure of depressive and anxiety disorder symptoms and diagnoses, in primary care depression RCTs (the Revised Clinical Interview Schedule: CIS-R). Two-stage random-effects meta-analyses were conducted. Results. Twelve (n = 6024) of thirteen eligible studies (n = 6175) provided individual patient data. There was a 31% (95%CI: 25 to 37) difference in depressive symptoms at 3–4 months per standard deviation increase in baseline depressive symptoms. Four additional factors: the duration of anxiety; duration of depression; comorbid panic disorder; and a history of antidepressant treatment were also independently associated with poorer prognosis. There was evidence that the difference in prognosis when these factors were combined could be of clinical importance. Adding these variables improved the amount of variance explained in 3–4 month depressive symptoms from 16% using depressive symptom severity alone to 27%. Risk of bias (assessed with QUIPS) was low in all studies and quality (assessed with GRADE) was high. Sensitivity analyses did not alter our conclusions. Conclusions. When adults seek treatment for depression clinicians should routinely assess for the duration of anxiety, duration of depression, comorbid panic disorder, and a history of antidepressant treatment alongside depressive symptom severity. This could provide clinicians and patients with useful and desired information to elucidate prognosis and aid the clinical management of depression. Introduction | en_GB |
dc.description.sponsorship | Medical Research Council (MRC) | en_GB |
dc.description.sponsorship | Wellcome Trust | en_GB |
dc.description.sponsorship | MQ Foundation | en_GB |
dc.description.sponsorship | National Institute of Health Research (NIHR) | en_GB |
dc.description.sponsorship | University College London | en_GB |
dc.description.sponsorship | University of Pennsylvania | en_GB |
dc.description.sponsorship | University of Southampton | en_GB |
dc.description.sponsorship | University of York | en_GB |
dc.description.sponsorship | University of Exeter | en_GB |
dc.identifier.citation | Published online 14 April 2021 | en_GB |
dc.identifier.doi | 10.1017/s0033291721001367 | |
dc.identifier.grantnumber | G0701013 | en_GB |
dc.identifier.grantnumber | 201292/Z/16/Z | en_GB |
dc.identifier.grantnumber | MC_UU_12023/21 | en_GB |
dc.identifier.grantnumber | MQDS16/72 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/125359 | |
dc.language.iso | en | en_GB |
dc.publisher | Cambridge University Press | en_GB |
dc.rights | © The Author(s), 2021. Open access. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. | en_GB |
dc.subject | Depression | en_GB |
dc.subject | individual patient data meta-analysis | en_GB |
dc.subject | prognosis | en_GB |
dc.subject | systematic review | en_GB |
dc.subject | treatment outcome | en_GB |
dc.title | The contribution of depressive ‘disorder characteristics’ to determinations of prognosis for adults with depression: an individual patient data meta-analysis | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2021-04-14T12:12:03Z | |
dc.identifier.issn | 0033-2917 | |
dc.description | This is the final version. Available on open access from Cambridge University Press via the DOI in this record. | en_GB |
dc.description | The supplementary material for this article can be found at https://doi.org/10.1017/S0033291721001367 | en_GB |
dc.identifier.eissn | 1469-8978 | |
dc.identifier.journal | Psychological Medicine | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0 | en_GB |
dcterms.dateAccepted | 2021-03-26 | |
exeter.funder | ::Medical Research Council (MRC) | en_GB |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2021-04-14 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2021-04-14T12:04:33Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2021-04-14T12:12:07Z | |
refterms.panel | A | en_GB |
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Except where otherwise noted, this item's licence is described as © The Author(s), 2021. Open access. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.