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A Patient Stratification Approach to Identifying the Likelihood of Continued Chronic Depression and Relapse Following Treatment for Depression
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 random...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8703621/ https://www.ncbi.nlm.nih.gov/pubmed/34945767 http://dx.doi.org/10.3390/jpm11121295 |
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author | Saunders, Rob Cohen, Zachary D. Ambler, Gareth DeRubeis, Robert J. Wiles, Nicola Kessler, David Gilbody, Simon Hollon, Steve D. Kendrick, Tony Watkins, Ed Richards, David Brabyn, Sally Littlewood, Elizabeth Sharp, Debbie Lewis, Glyn Pilling, Steve Buckman, Joshua E. J. |
author_facet | Saunders, Rob Cohen, Zachary D. Ambler, Gareth DeRubeis, Robert J. Wiles, Nicola Kessler, David Gilbody, Simon Hollon, Steve D. Kendrick, Tony Watkins, Ed Richards, David Brabyn, Sally Littlewood, Elizabeth Sharp, Debbie Lewis, Glyn Pilling, Steve Buckman, Joshua E. J. |
author_sort | Saunders, Rob |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8703621 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-87036212021-12-25 A Patient Stratification Approach to Identifying the Likelihood of Continued Chronic Depression and Relapse Following Treatment for Depression Saunders, Rob Cohen, Zachary D. Ambler, Gareth DeRubeis, Robert J. Wiles, Nicola Kessler, David Gilbody, Simon Hollon, Steve D. Kendrick, Tony Watkins, Ed Richards, David Brabyn, Sally Littlewood, Elizabeth Sharp, Debbie Lewis, Glyn Pilling, Steve Buckman, Joshua E. J. J Pers Med Article 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. MDPI 2021-12-04 /pmc/articles/PMC8703621/ /pubmed/34945767 http://dx.doi.org/10.3390/jpm11121295 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/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/). |
spellingShingle | Article Saunders, Rob Cohen, Zachary D. Ambler, Gareth DeRubeis, Robert J. Wiles, Nicola Kessler, David Gilbody, Simon Hollon, Steve D. Kendrick, Tony Watkins, Ed Richards, David Brabyn, Sally Littlewood, Elizabeth Sharp, Debbie Lewis, Glyn Pilling, Steve Buckman, Joshua E. J. A Patient Stratification Approach to Identifying the Likelihood of Continued Chronic Depression and Relapse Following Treatment for Depression |
title | A Patient Stratification Approach to Identifying the Likelihood of Continued Chronic Depression and Relapse Following Treatment for Depression |
title_full | A Patient Stratification Approach to Identifying the Likelihood of Continued Chronic Depression and Relapse Following Treatment for Depression |
title_fullStr | A Patient Stratification Approach to Identifying the Likelihood of Continued Chronic Depression and Relapse Following Treatment for Depression |
title_full_unstemmed | A Patient Stratification Approach to Identifying the Likelihood of Continued Chronic Depression and Relapse Following Treatment for Depression |
title_short | A Patient Stratification Approach to Identifying the Likelihood of Continued Chronic Depression and Relapse Following Treatment for Depression |
title_sort | patient stratification approach to identifying the likelihood of continued chronic depression and relapse following treatment for depression |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8703621/ https://www.ncbi.nlm.nih.gov/pubmed/34945767 http://dx.doi.org/10.3390/jpm11121295 |
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