Cohen, Zachary D;
DeRubeis, Robert J;
Hayes, Rachel;
Watkins, Edward R;
Lewis, Glyn;
Byng, Richard;
Byford, Sarah;
... Schweizer, Susanne; + view all
(2022)
The Development and Internal Evaluation of a Predictive Model to Identify for Whom Mindfulness-Based Cognitive Therapy Offers Superior Relapse Prevention for Recurrent Depression Versus Maintenance Antidepressant Medication.
Clinical Psychological Science
10.1177/21677026221076832.
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Abstract
Depression is highly recurrent, even following successful pharmacological and/or psychological intervention. We aimed to develop clinical prediction models to inform adults with recurrent depression choosing between antidepressant medication (ADM) maintenance or switching to mindfulness-based cognitive therapy (MBCT). Using previously published data ( N = 424), we constructed prognostic models using elastic-net regression that combined demographic, clinical, and psychological factors to predict relapse at 24 months under ADM or MBCT. Only the ADM model (discrimination performance: area under the curve [AUC] = .68) predicted relapse better than baseline depression severity (AUC = .54; one-tailed DeLong’s test: z = 2.8, p = .003). Individuals with the poorest ADM prognoses who switched to MBCT had better outcomes compared with individuals who maintained ADM (48% vs. 70% relapse, respectively; superior survival times, z = −2.7, p = .008). For individuals with moderate to good ADM prognoses, both treatments resulted in similar likelihood of relapse. If replicated, the results suggest that predictive modeling can inform clinical decision-making around relapse prevention in recurrent depression.
| Type: | Article |
|---|---|
| Title: | The Development and Internal Evaluation of a Predictive Model to Identify for Whom Mindfulness-Based Cognitive Therapy Offers Superior Relapse Prevention for Recurrent Depression Versus Maintenance Antidepressant Medication |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/21677026221076832 |
| Publisher version: | https://doi.org/10.1177/21677026221076832 |
| Language: | English |
| Additional information: | This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ |
| Keywords: | Social Sciences, Science & Technology, Life Sciences & Biomedicine, Psychology, Clinical, Psychiatry, Psychology, antidepressant medication, depression, mindfulness-based cognitive therapy, precision medicine, relapse prevention, SHARED DECISION-MAKING, LONG-TERM USE, STEPPED CARE, SAMPLE-SIZE, SELECTION, REGULARIZATION, IMPUTATION, DISORDERS, VARIABLES, EFFICACY |
| UCL classification: | 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 > Division of Psychiatry UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10148674 |
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