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What factors indicate prognosis for adults with depression in primary care?: A protocol for meta-analyses of individual patient data using the Dep-GP database

What factors indicate prognosis for adults with depression in primary care?: A protocol for meta-analyses of individual patient data using the Dep-GP database
What factors indicate prognosis for adults with depression in primary care?: A protocol for meta-analyses of individual patient data using the Dep-GP database

Background: Pre-treatment severity is a key indicator of prognosis for those with depression. Knowledge is limited on how best to encompass severity of disorders. A number of non-severity related factors such as social support and life events are also indicators of prognosis. It is not clear whether this holds true after adjusting for pre-treatment severity as a) a depressive symptom scale score, and b) a broader construct encompassing symptom severity and related indicators: "disorder severity". In order to investigate this, data from the individual participants of clinical trials which have measured a breadth of "disorder severity" related factors are needed. Aims: 1) To assess the association between outcomes for adults seeking treatment for depression and the severity of depression pre-treatment, considered both as i) depressive symptom severity only and ii) "disorder severity" which includes depressive symptom severity and comorbid anxiety, chronicity, history of depression, history of previous treatment, functional impairment and health-related quality of life. 2) To determine whether i) social support, ii) life events, iii) alcohol misuse, and iv) demographic factors (sex, age, ethnicity, marital status, employment status, level of educational attainment, and financial wellbeing) are prognostic indicators of outcomes, independent of baseline "disorder severity" and the type of treatment received. Methods: Databases were searched for randomised clinical trials (RCTs) that recruited adults seeking treatment for depression from their general practitioners and used the same diagnostic and screening instrument to measure severity at baseline - the Revised Clinical Interview Schedule; outcome measures could differ between studies. Chief investigators of all studies meeting inclusion criteria were contacted and individual patient data (IPD) were requested. Conclusions: In total 15 RCTs met inclusion criteria. The Dep-GP database will include the 6271 participants from the 13 studies that provided IPD. This protocol outlines how these data will be analysed. Registration: PROSPERO CRD42019129512 (01/04/2019).

2398-502X
69
Buckman, Joshua E J
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Saunders, Rob
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Cohen, Zachary D
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Clarke, Katherine
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Ambler, Gareth
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DeRubeis, Robert J
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Gilbody, Simon
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Hollon, Steven D
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Kendrick, Tony
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Watkins, Edward
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White, Ian R
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Lewis, Glyn
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Pilling, Stephen
f8b9c11e-7720-493c-8739-7813980ff3e4
Buckman, Joshua E J
72f4352d-7903-416f-82df-f69d90308129
Saunders, Rob
14f8666e-a131-4130-a7b1-a358d84d5cb2
Cohen, Zachary D
2ac2bcd9-b47b-458c-a241-cccd311c1e8a
Clarke, Katherine
cddc1aed-8a81-4870-8806-c9621c7ab782
Ambler, Gareth
3b9b18c5-1f7b-4608-b86f-30491d1c2418
DeRubeis, Robert J
311dbb2e-7779-4c26-95fb-895a3853284c
Gilbody, Simon
6d135882-a8df-444c-85aa-980dddef45a5
Hollon, Steven D
faca54db-7076-4c3c-955e-03333b2e7a54
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5
Watkins, Edward
4474dca0-035b-4aba-b3fb-b6d7180abfb9
White, Ian R
f094d26e-f8b6-4df6-8a11-c60e5da7c956
Lewis, Glyn
11aed8f6-3905-455e-8e89-34147a5e5d26
Pilling, Stephen
f8b9c11e-7720-493c-8739-7813980ff3e4

Buckman, Joshua E J, Saunders, Rob, Cohen, Zachary D, Clarke, Katherine, Ambler, Gareth, DeRubeis, Robert J, Gilbody, Simon, Hollon, Steven D, Kendrick, Tony, Watkins, Edward, White, Ian R, Lewis, Glyn and Pilling, Stephen (2020) What factors indicate prognosis for adults with depression in primary care?: A protocol for meta-analyses of individual patient data using the Dep-GP database. Wellcome Open Research, 4, 69. (doi:10.12688/wellcomeopenres.15225.3).

Record type: Article

Abstract

Background: Pre-treatment severity is a key indicator of prognosis for those with depression. Knowledge is limited on how best to encompass severity of disorders. A number of non-severity related factors such as social support and life events are also indicators of prognosis. It is not clear whether this holds true after adjusting for pre-treatment severity as a) a depressive symptom scale score, and b) a broader construct encompassing symptom severity and related indicators: "disorder severity". In order to investigate this, data from the individual participants of clinical trials which have measured a breadth of "disorder severity" related factors are needed. Aims: 1) To assess the association between outcomes for adults seeking treatment for depression and the severity of depression pre-treatment, considered both as i) depressive symptom severity only and ii) "disorder severity" which includes depressive symptom severity and comorbid anxiety, chronicity, history of depression, history of previous treatment, functional impairment and health-related quality of life. 2) To determine whether i) social support, ii) life events, iii) alcohol misuse, and iv) demographic factors (sex, age, ethnicity, marital status, employment status, level of educational attainment, and financial wellbeing) are prognostic indicators of outcomes, independent of baseline "disorder severity" and the type of treatment received. Methods: Databases were searched for randomised clinical trials (RCTs) that recruited adults seeking treatment for depression from their general practitioners and used the same diagnostic and screening instrument to measure severity at baseline - the Revised Clinical Interview Schedule; outcome measures could differ between studies. Chief investigators of all studies meeting inclusion criteria were contacted and individual patient data (IPD) were requested. Conclusions: In total 15 RCTs met inclusion criteria. The Dep-GP database will include the 6271 participants from the 13 studies that provided IPD. This protocol outlines how these data will be analysed. Registration: PROSPERO CRD42019129512 (01/04/2019).

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e-pub ahead of print date: 16 April 2019
Published date: 1 April 2020

Identifiers

Local EPrints ID: 448171
URI: http://eprints.soton.ac.uk/id/eprint/448171
ISSN: 2398-502X
PURE UUID: 12995f33-4cf0-4ca8-905c-70141e2e2021
ORCID for Tony Kendrick: ORCID iD orcid.org/0000-0003-1618-9381

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Date deposited: 14 Apr 2021 16:30
Last modified: 02 Sep 2022 01:36

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Contributors

Author: Joshua E J Buckman
Author: Rob Saunders
Author: Zachary D Cohen
Author: Katherine Clarke
Author: Gareth Ambler
Author: Robert J DeRubeis
Author: Simon Gilbody
Author: Steven D Hollon
Author: Tony Kendrick ORCID iD
Author: Edward Watkins
Author: Ian R White
Author: Glyn Lewis
Author: Stephen Pilling

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