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Understanding prognosis independent of treatment for adults with depression in primary care

Buckman, Joshua Eusty Jonathan; (2021) Understanding prognosis independent of treatment for adults with depression in primary care. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

This thesis details the rationale and methods for compiling a large individual patient data (IPD) dataset of adults treated for depression in primary care, for the purpose of identifying predictors of prognosis independent of treatment. I present a narrative review of the knowledge of factors associated with prognosis for adults with depression, a narrative review of the merits and difficulties of utilising IPD data, and a protocol for a series of systematic reviews with IPD meta-analyses seeking to meet the above aim. I then present three such IPD meta-analyses. These focus on the associations between depressed patient’s pre-treatment characteristics, and i) prognosis independent of a range of treatments for depression in primary care, and ii) attrition from treatment. The first of these IPD meta-analyses is centred on depressive symptom severity and a group of factors that are associated with the degree of severity of a patient’s experience of depression, but which are separate from depressive symptoms, (I refer to these as indicators of depressive ‘disorder severity’). The second is centred on perceived social support. The third is centred on adverse life events in the six months prior to starting treatment, socio-demographics (age, gender, ethnicity, marital status, employment status, financial wellbeing, housing tenancy, and the highest level of educational attainment), and comorbid long-term physical health conditions. The thesis finishes with a critical review of the implications of these analyses, consideration of future directions and implications for clinical practice.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Understanding prognosis independent of treatment for adults with depression in primary care
Event: UCL (University College London)
Language: English
Additional information: Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/10118975
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