In:
Psychological Medicine, Cambridge University Press (CUP), Vol. 53, No. 8 ( 2023-06), p. 3591-3600
Abstract:
Fewer than half of patients with major depressive disorder (MDD) respond to psychotherapy. Pre-emptively informing patients of their likelihood of responding could be useful as part of a patient-centered treatment decision-support plan. Methods This prospective observational study examined a national sample of 807 patients beginning psychotherapy for MDD at the Veterans Health Administration. Patients completed a self-report survey at baseline and 3-months follow-up (data collected 2018–2020). We developed a machine learning (ML) model to predict psychotherapy response at 3 months using baseline survey, administrative, and geospatial variables in a 70% training sample. Model performance was then evaluated in the 30% test sample. Results 32.0% of patients responded to treatment after 3 months. The best ML model had an AUC (SE) of 0.652 (0.038) in the test sample. Among the one-third of patients ranked by the model as most likely to respond, 50.0% in the test sample responded to psychotherapy. In comparison, among the remaining two-thirds of patients, 〈 25% responded to psychotherapy. The model selected 43 predictors, of which nearly all were self-report variables. Conclusions Patients with MDD could pre-emptively be informed of their likelihood of responding to psychotherapy using a prediction tool based on self-report data. This tool could meaningfully help patients and providers in shared decision-making, although parallel information about the likelihood of responding to alternative treatments would be needed to inform decision-making across multiple treatments.
Type of Medium:
Online Resource
ISSN:
0033-2917
,
1469-8978
DOI:
10.1017/S0033291722000228
Language:
English
Publisher:
Cambridge University Press (CUP)
Publication Date:
2023
detail.hit.zdb_id:
1470300-2
SSG:
5,2