A patient stratification approach to identifying the likelihood of continued chronic depression and relapse following Treatment for depression.
dc.contributor.author | Saunders, R | |
dc.contributor.author | Cohen, ZD | |
dc.contributor.author | Ambler, G | |
dc.contributor.author | DeRubeis, RJ | |
dc.contributor.author | Wiles, N | |
dc.contributor.author | Kessler, D | |
dc.contributor.author | Gilbody, S | |
dc.contributor.author | Hollon, SD | |
dc.contributor.author | Kendrick, T | |
dc.contributor.author | Watkins, E | |
dc.contributor.author | Richards, D | |
dc.contributor.author | Brabyn, S | |
dc.contributor.author | Littlewood, E | |
dc.contributor.author | Sharp, D | |
dc.contributor.author | Lewis, G | |
dc.contributor.author | Pilling, S | |
dc.contributor.author | Buckman, JEJ | |
dc.date.accessioned | 2022-07-27T09:05:52Z | |
dc.date.issued | 2021-12-04 | |
dc.date.updated | 2022-07-27T08:26:12Z | |
dc.description.abstract | BACKGROUND: Subgrouping methods have the potential to support treatment decision making for patients with depression. Such approaches have not been used to study the continued course of depression or likelihood of relapse following treatment. METHOD: Data from individual participants of seven randomised controlled trials were analysed. Latent profile analysis was used to identify subgroups based on baseline characteristics. Associations between profiles and odds of both continued chronic depression and relapse up to one year post-treatment were explored. Differences in outcomes were investigated within profiles for those treated with antidepressants, psychological therapy, and usual care. RESULTS: Seven profiles were identified; profiles with higher symptom severity and long durations of both anxiety and depression at baseline were at higher risk of relapse and of chronic depression. Members of profile five (likely long durations of depression and anxiety, moderately-severe symptoms, and past antidepressant use) appeared to have better outcomes with psychological therapies: antidepressants vs. psychological therapies (OR (95% CI) for relapse = 2.92 (1.24-6.87), chronic course = 2.27 (1.27-4.06)) and usual care vs. psychological therapies (relapse = 2.51 (1.16-5.40), chronic course = 1.98 (1.16-3.37)). CONCLUSIONS: Profiles at greater risk of poor outcomes could benefit from more intensive treatment and frequent monitoring. Patients in profile five may benefit more from psychological therapies than other treatments. | en_GB |
dc.description.sponsorship | Wellcome Trust | en_GB |
dc.description.sponsorship | MQ Foundation | en_GB |
dc.description.sponsorship | National Institute for Health Research | en_GB |
dc.description.sponsorship | Higher Education Funding Council for England | en_GB |
dc.description.sponsorship | Royal College of Psychiatrists | en_GB |
dc.description.sponsorship | University College London | en_GB |
dc.description.sponsorship | Vanderbilt University | en_GB |
dc.description.sponsorship | University of Southampton | en_GB |
dc.description.sponsorship | University of Exeter | en_GB |
dc.description.sponsorship | University of York | en_GB |
dc.description.sponsorship | NIHR Biomedical Research Centre at the University Hospitals Bristol and Weston NHS Foundation Trust | en_GB |
dc.description.sponsorship | University of Bristol | en_GB |
dc.format.extent | 1295- | |
dc.format.medium | Electronic | |
dc.identifier.citation | Vol. 11, No. 12, article 1295 | en_GB |
dc.identifier.doi | https://doi.org/10.3390/jpm11121295 | |
dc.identifier.grantnumber | 201292/Z/16/Z | en_GB |
dc.identifier.grantnumber | MQDS16/72 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/130406 | |
dc.identifier | ORCID: 0000-0002-8821-5027 (Richards, David) | |
dc.identifier | ResearcherID: B-4807-2009 (Richards, David) | |
dc.language.iso | en | en_GB |
dc.publisher | MDPI | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/34945767 | en_GB |
dc.rights | © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). | en_GB |
dc.subject | depression | en_GB |
dc.subject | latent profile analysis | en_GB |
dc.subject | patient stratification | en_GB |
dc.subject | personalised medicine | en_GB |
dc.subject | primary care | en_GB |
dc.title | A patient stratification approach to identifying the likelihood of continued chronic depression and relapse following Treatment for depression. | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2022-07-27T09:05:52Z | |
dc.identifier.issn | 2075-4426 | |
exeter.article-number | ARTN 1295 | |
exeter.place-of-publication | Switzerland | |
dc.description | This is the final version. Available from MDPI via the DOI in this record. | en_GB |
dc.description | Data Availability Statement: Requests for sharing of the IPD used in this study can be made to the corresponding author, any sharing of data will be subject to obtaining appropriate agreements from the chief investigators or data custodians for each individual trial dataset used here. | en_GB |
dc.identifier.journal | Journal of Personalized Medicine | en_GB |
dc.relation.ispartof | J Pers Med, 11(12) | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2021-11-17 | |
dc.rights.license | CC BY | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2021-12-04 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2022-07-27T08:58:57Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2022-07-27T09:05:53Z | |
refterms.panel | A | en_GB |
refterms.dateFirstOnline | 2021-12-04 |
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Except where otherwise noted, this item's licence is described as © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).