ORCID
- Richard Byng: 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 Link
Publication Date
2022-04-29
Publication Title
Clinical Psychological Science
Volume
11
Issue
1
ISSN
2167-7026
Acceptance Date
2022-01-11
Deposit Date
2022-06-28
Embargo Period
2022-06-29
Funding
This research was funded by the National Institute for Health Research (NIHR) Health Technology Assessment program (Project 08/56/01). T. Dalgleish was partly supported by the National Institute for Health Research Cambridge Biomedical Research Centre and the UK Medical Research Council (Grant SUAG/043 G101400). S. Schweizer was supported by the Wellcome Trust (Grant 209127/ Z/17/Z). Z. D. Cohen and R. J. DeRubeis were partly supported by the MQ Foundation (Grant MQ14PM_27). W. Kuyken and C. Crane were supported by the Wellcome Trust (Grant 104908/Z/14/Z and 107496/Z/15/Z). R. Byng was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula at the Royal Devon and Exeter National Health Service Foundation Trust.
Keywords
antidepressant medication, depression, mindfulness-based cognitive therapy, precision medicine, relapse prevention
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Cohen, Z., 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, 11(1). Available at: 10.1177/21677026221076832
