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A prediction algorithm for first onset of major depression in the general population: development and validation
  1. JianLi Wang1,
  2. Jitender Sareen2,
  3. Scott Patten3,
  4. James Bolton2,
  5. Norbert Schmitz4,
  6. Arden Birney3
  1. 1Departments of Psychiatry and of Community Health Science, Faculty of Medicine, University of Calgary, Calgary, Canada
  2. 2Department of Psychiatry, Faculty of Medicine, University of Manitoba, Winnipeg, Canada
  3. 3Department of Community Health Science, Faculty of Medicine, University of Calgary, Calgary, Canada
  4. 4Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Canada
  1. Correspondence to Dr JianLi Wang, Departments of Psychiatry and of Community Health Science, Faculty of Medicine, University of Calgary, Room 4D69, TRW Building, 3280 Hospital Dr. NW, Calgary, Alberta, Canada T2N 4Z6; jlwang{at}ucalgary.ca

Abstract

Objective Prediction algorithms are useful for making clinical decisions and for population health planning. However, such prediction algorithms for first onset of major depression do not exist. The objective of this study was to develop and validate a prediction algorithm for first onset of major depression in the general population.

Methods Longitudinal study design with approximate 3-year follow-up. The study was based on data from a nationally representative sample of the US general population. A total of 28 059 individuals who participated in Waves 1 and 2 of the US National Epidemiologic Survey on Alcohol and Related Conditions and who had not had major depression at Wave 1 were included. The prediction algorithm was developed using logistic regression modelling in 21 813 participants from three census regions. The algorithm was validated in participants from the 4th census region (n=6246). Major depression occurred since Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions, assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule–diagnostic and statistical manual for mental disorders IV.

Results A prediction algorithm containing 17 unique risk factors was developed. The algorithm had good discriminative power (C statistics=0.7538, 95% CI 0.7378 to 0.7699) and excellent calibration (F-adjusted test=1.00, p=0.448) with the weighted data. In the validation sample, the algorithm had a C statistic of 0.7259 and excellent calibration (Hosmer-Lemeshow χ2=3.41, p=0.906).

Conclusions The developed prediction algorithm has good discrimination and calibration capacity. It can be used by clinicians, mental health policy-makers and service planners and the general public to predict future risk of having major depression. The application of the algorithm may lead to increased personalisation of treatment, better clinical decisions and more optimal mental health service planning.

  • Depression
  • Longitudinal Studies
  • Mental Health
  • Prevention
  • Public Health Policy

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