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
Year: 2022
Type: article
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.
Source: Clinical Psychological Science
Institutions: University of California, Los Angeles, University of Pennsylvania, University of Exeter, National Institute for Health and Care Research, NIHR Applied Research Collaboration South West Peninsula, University College London, University of Plymouth, King's College London, University of Oxford, MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridgeshire and Peterborough NHS Foundation Trust, Medical Research Council, UNSW Sydney
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $3,500
Awards: Promoting mental health and building resilience in adolescence: Investigating mindfulness and attentional control., The effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse/recurrence: results of a randomised controlled trial (the PREVENT study), G1618645035, G3594153814, G3988682191, G5339972315, G5696211195, Promoting mental health and building resilience in adolescence: Investigating mindfulness and attentional control., Promoting mental health and building resilience in adolescence: Investigating mindfulness and attentional control., Promoting mental health and building resilience in adolescence: Investigating mindfulness and attentional control., G8006041828, G8074725857, Enhancing emotion-regulation in adolescence: A developmental window of opportunity, G862767094, G8785276084, G9000128035
OpenAlex ID: W4226036705