ORCID
- Byng, Richard: 0000-0001-7411-9467
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.
DOI
10.1177/21677026221076832
Publication Date
2022-04-29
Publication Title
Clinical Psychological Science
ISSN
2167-7026
Embargo Period
2022-06-29
Organisational Unit
Peninsula Medical School
Recommended Citation
Cohen, Z. D., DeRubeis, R., Hayes, R., Watkins, E., Lewis, G., Byng, R., Byford, S., Crane, C., Kuyken, W., Dalgleish, T., & Schweizer, S. (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, . Available at: https://doi.org/10.1177/21677026221076832
