Role of age, gender and marital status in prognosis for adults with depression: An individual patient data meta-analysis.
dc.contributor.author | Buckman, JEJ | |
dc.contributor.author | Saunders, R | |
dc.contributor.author | Stott, J | |
dc.contributor.author | Arundell, L-L | |
dc.contributor.author | O'Driscoll, C | |
dc.contributor.author | Davies, MR | |
dc.contributor.author | Eley, TC | |
dc.contributor.author | Hollon, SD | |
dc.contributor.author | Kendrick, T | |
dc.contributor.author | Ambler, G | |
dc.contributor.author | Cohen, ZD | |
dc.contributor.author | Watkins, E | |
dc.contributor.author | Gilbody, S | |
dc.contributor.author | Wiles, N | |
dc.contributor.author | Kessler, D | |
dc.contributor.author | Richards, D | |
dc.contributor.author | Brabyn, S | |
dc.contributor.author | Littlewood, E | |
dc.contributor.author | DeRubeis, RJ | |
dc.contributor.author | Lewis, G | |
dc.contributor.author | Pilling, S | |
dc.date.accessioned | 2022-07-27T09:23:36Z | |
dc.date.issued | 2021-06-04 | |
dc.date.updated | 2022-07-27T08:29:32Z | |
dc.description.abstract | AIMS: To determine whether age, gender and marital status are associated with prognosis for adults with depression who sought treatment in primary care. METHODS: Medline, Embase, PsycINFO and Cochrane Central were searched from inception to 1st December 2020 for randomised controlled trials (RCTs) of adults seeking treatment for depression from their general practitioners, that used the Revised Clinical Interview Schedule so that there was uniformity in the measurement of clinical prognostic factors, and that reported on age, gender and marital status. Individual participant data were gathered from all nine eligible RCTs (N = 4864). Two-stage random-effects meta-analyses were conducted to ascertain the independent association between: (i) age, (ii) gender and (iii) marital status, and depressive symptoms at 3-4, 6-8,<Vinod: Please carry out the deletion of serial commas throughout the article> and 9-12 months post-baseline and remission at 3-4 months. Risk of bias was evaluated using QUIPS and quality was assessed using GRADE. PROSPERO registration: CRD42019129512. Pre-registered protocol https://osf.io/e5zup/. RESULTS: There was no evidence of an association between age and prognosis before or after adjusting for depressive 'disorder characteristics' that are associated with prognosis (symptom severity, durations of depression and anxiety, comorbid panic disorderand a history of antidepressant treatment). Difference in mean depressive symptom score at 3-4 months post-baseline per-5-year increase in age = 0(95% CI: -0.02 to 0.02). There was no evidence for a difference in prognoses for men and women at 3-4 months or 9-12 months post-baseline, but men had worse prognoses at 6-8 months (percentage difference in depressive symptoms for men compared to women: 15.08% (95% CI: 4.82 to 26.35)). However, this was largely driven by a single study that contributed data at 6-8 months and not the other time points. Further, there was little evidence for an association after adjusting for depressive 'disorder characteristics' and employment status (12.23% (-1.69 to 28.12)). Participants that were either single (percentage difference in depressive symptoms for single participants: 9.25% (95% CI: 2.78 to 16.13) or no longer married (8.02% (95% CI: 1.31 to 15.18)) had worse prognoses than those that were married, even after adjusting for depressive 'disorder characteristics' and all available confounders. CONCLUSION: Clinicians and researchers will continue to routinely record age and gender, but despite their importance for incidence and prevalence of depression, they appear to offer little information regarding prognosis. Patients that are single or no longer married may be expected to have slightly worse prognoses than those that are married. Ensuring this is recorded routinely alongside depressive 'disorder characteristics' in clinic may be important. | en_GB |
dc.description.sponsorship | Wellcome Trust | en_GB |
dc.description.sponsorship | MQ Foundation | en_GB |
dc.description.sponsorship | Higher Education Funding Council for England | en_GB |
dc.description.sponsorship | National Institute for Health Research | en_GB |
dc.description.sponsorship | Alzheimer’s Society | en_GB |
dc.description.sponsorship | University College London Hospitals Biomedical Research Centre | 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 | e42- | |
dc.format.medium | Electronic | |
dc.identifier.citation | Vol. 30, article e42 | en_GB |
dc.identifier.doi | https://doi.org/10.1017/S2045796021000342 | |
dc.identifier.grantnumber | 201292/Z/16/Z | en_GB |
dc.identifier.grantnumber | MQDS16/72 | en_GB |
dc.identifier.grantnumber | 457 (AS-PG-18-013) | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/130409 | |
dc.identifier | ORCID: 0000-0002-8821-5027 (Richards, D) | |
dc.identifier | ResearcherID: B-4807-2009 (Richards, D) | |
dc.language.iso | en | en_GB |
dc.publisher | Cambridge University Press | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/34085616 | en_GB |
dc.rights | © The Author(s), 2021. 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 outcomes | en_GB |
dc.title | Role of age, gender and marital status in prognosis for adults with depression: An individual patient data meta-analysis. | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2022-07-27T09:23:36Z | |
dc.identifier.issn | 2045-7960 | |
exeter.article-number | e42 | |
exeter.place-of-publication | England | |
dc.description | This is the final version. Available from Cambridge University Press via the DOI in this record. | en_GB |
dc.description | Data availability: 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.eissn | 2045-7979 | |
dc.identifier.journal | Epidemiology and Psychiatric Sciences | en_GB |
dc.relation.ispartof | Epidemiol Psychiatr Sci, 30 | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2021-05-09 | |
dc.rights.license | CC BY | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2021-06-04 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2022-07-27T09:16:53Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2022-07-27T09:23:37Z | |
refterms.panel | A | en_GB |
refterms.dateFirstOnline | 2021-06-04 |
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Except where otherwise noted, this item's licence is described as © The Author(s), 2021. 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.