TY  - JOUR
PY  - 2021//
TI  - Life events and treatment prognosis for depression: a systematic review and individual patient data meta-analysis
JO  - Journal of affective disorders
A1  - Buckman, Dr Joshua E. J.
A1  - Saunders, Rob
A1  - Arundell, Laura-Louise
A1  - Oshinowo, Iyinoluwa D.
A1  - Cohen, Zachary D.
A1  - O'Driscoll, Ciaran
A1  - Barnett, Phoebe
A1  - Stott, Joshua
A1  - Ambler, Gareth
A1  - Gilbody, Prof Simon
A1  - Hollon, Prof Steven D.
A1  - Kendrick, Prof Tony
A1  - Watkins, Prof Edward
A1  - Eley, Prof Thalia C.
A1  - Skelton, Megan
A1  - Wiles, Prof Nicola
A1  - Kessler, Prof David
A1  - DeRubeis, Prof Robert J.
A1  - Lewis, Prof Glyn
A1  - Pilling, Prof Stephen
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: To investigate associations between major life events and prognosis independent of treatment type: 1) after adjusting for clinical prognostic factors and socio-demographics; 2) among patients with depressive episodes at least six-months long; and 3) patients with a first life-time depressive episode. <br><br>METHODS: Six RCTs of adults seeking treatment for depression in primary care met eligibility criteria, individual patient data (IPD) were collated from all six (n=2858). Participants were randomized to any treatment and completed the same baseline assessment of life events, demographics and clinical prognostic factors. Two-stage random effects meta-analyses were conducted. <br><br>RESULTS: Reporting any major life events was associated with poorer prognosis regardless of treatment type. Controlling for baseline clinical factors, socio-demographics and social support resulted in minimal residual evidence of associations between life events and treatment prognosis. However, removing factors that might mediate the relationships between life events and outcomes reporting: arguments/disputes, problem debt, violent crime, losing one's job, and three or more life events were associated with considerably worse prognoses (percentage difference in 3-4 months depressive symptoms compared to no reported life events =30.3%(95%CI: 18.4-43.3)). <br><br>CONCLUSIONS: Assessing for clinical prognostic factors, social support, and socio-demographics is likely to be more informative for prognosis than assessing self-reported recent major life events. However, clinicians might find it useful to ask about such events, and if they are still affecting the patient, consider interventions to tackle problems related to those events (e.g. employment support, mediation, or debt advice). Further investigations of the efficacy of such interventions will be important.<p />  <p>Language: en</p>
LA  - en
SN  - 0165-0327
UR  - http://dx.doi.org/10.1016/j.jad.2021.12.030
ID  - ref1
ER  -