Indicators to facilitate the early identification of patients with major depressive disorder in need of highly specialized care: A concept mapping study

on behalf of the Decision Tool Unipolar Depression Consortium

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Early identification of the subgroup of patients with major depressive disorder (MDD) in need of highly specialized care could enhance personalized intervention. This, in turn, may reduce the number of treatment steps needed to achieve and sustain an adequate treatment response. The aim of this study was to identify patient-related indicators that could facilitate the early identification of the subgroup of patients with MDD in need of highly specialized care. Methods: Initial patient indicators were derived from a systematic review. Subsequently, a structured conceptualization methodology known as concept mapping was employed to complement the initial list of indicators by clinical expertise and develop a consensus-based conceptual framework. Subject-matter experts were invited to participate in the subsequent steps (brainstorming, sorting, and rating) of the concept mapping process. A final concept map solution was generated using nonmetric multidimensional scaling and agglomerative hierarchical cluster analyses. Results: In total, 67 subject-matter experts participated in the concept mapping process. The final concept map revealed the following 10 major clusters of indicators: 1-depression severity, 2-onset and (treatment) course, 3-comorbid personality disorder, 4-comorbid substance use disorder, 5-other psychiatric comorbidity, 6-somatic comorbidity, 7-maladaptive coping, 8-childhood trauma, 9-social factors, and 10-psychosocial dysfunction. Conclusions: The study findings highlight the need for a comprehensive assessment of patient indicators in determining the need for highly specialized care, and suggest that the treatment allocation of patients with MDD to highly specialized mental healthcare settings should be guided by the assessment of clinical and nonclinical patient factors.

Original languageEnglish
Pages (from-to)346-352
Number of pages7
JournalDepression and Anxiety
Volume35
Issue number4
DOIs
Publication statusPublished - 1 Apr 2018

Cite this

@article{4988d4380fc741dca18f4d81346057f1,
title = "Indicators to facilitate the early identification of patients with major depressive disorder in need of highly specialized care: A concept mapping study",
abstract = "Background: Early identification of the subgroup of patients with major depressive disorder (MDD) in need of highly specialized care could enhance personalized intervention. This, in turn, may reduce the number of treatment steps needed to achieve and sustain an adequate treatment response. The aim of this study was to identify patient-related indicators that could facilitate the early identification of the subgroup of patients with MDD in need of highly specialized care. Methods: Initial patient indicators were derived from a systematic review. Subsequently, a structured conceptualization methodology known as concept mapping was employed to complement the initial list of indicators by clinical expertise and develop a consensus-based conceptual framework. Subject-matter experts were invited to participate in the subsequent steps (brainstorming, sorting, and rating) of the concept mapping process. A final concept map solution was generated using nonmetric multidimensional scaling and agglomerative hierarchical cluster analyses. Results: In total, 67 subject-matter experts participated in the concept mapping process. The final concept map revealed the following 10 major clusters of indicators: 1-depression severity, 2-onset and (treatment) course, 3-comorbid personality disorder, 4-comorbid substance use disorder, 5-other psychiatric comorbidity, 6-somatic comorbidity, 7-maladaptive coping, 8-childhood trauma, 9-social factors, and 10-psychosocial dysfunction. Conclusions: The study findings highlight the need for a comprehensive assessment of patient indicators in determining the need for highly specialized care, and suggest that the treatment allocation of patients with MDD to highly specialized mental healthcare settings should be guided by the assessment of clinical and nonclinical patient factors.",
keywords = "depressive disorder, disease management, major, precision medicine, tertiary healthcare",
author = "{on behalf of the Decision Tool Unipolar Depression Consortium} and {van Krugten}, {F. C.W.} and M. Goorden and {van Balkom}, {A. J.L.M.} and J. Spijker and Brouwer, {W. B.F.} and {Hakkaart-van Roijen}, L.",
year = "2018",
month = "4",
day = "1",
doi = "10.1002/da.22741",
language = "English",
volume = "35",
pages = "346--352",
journal = "Depression and Anxiety",
issn = "1091-4269",
publisher = "Wiley-Blackwell",
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}

Indicators to facilitate the early identification of patients with major depressive disorder in need of highly specialized care : A concept mapping study. / on behalf of the Decision Tool Unipolar Depression Consortium.

In: Depression and Anxiety, Vol. 35, No. 4, 01.04.2018, p. 346-352.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Indicators to facilitate the early identification of patients with major depressive disorder in need of highly specialized care

T2 - A concept mapping study

AU - on behalf of the Decision Tool Unipolar Depression Consortium

AU - van Krugten, F. C.W.

AU - Goorden, M.

AU - van Balkom, A. J.L.M.

AU - Spijker, J.

AU - Brouwer, W. B.F.

AU - Hakkaart-van Roijen, L.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Background: Early identification of the subgroup of patients with major depressive disorder (MDD) in need of highly specialized care could enhance personalized intervention. This, in turn, may reduce the number of treatment steps needed to achieve and sustain an adequate treatment response. The aim of this study was to identify patient-related indicators that could facilitate the early identification of the subgroup of patients with MDD in need of highly specialized care. Methods: Initial patient indicators were derived from a systematic review. Subsequently, a structured conceptualization methodology known as concept mapping was employed to complement the initial list of indicators by clinical expertise and develop a consensus-based conceptual framework. Subject-matter experts were invited to participate in the subsequent steps (brainstorming, sorting, and rating) of the concept mapping process. A final concept map solution was generated using nonmetric multidimensional scaling and agglomerative hierarchical cluster analyses. Results: In total, 67 subject-matter experts participated in the concept mapping process. The final concept map revealed the following 10 major clusters of indicators: 1-depression severity, 2-onset and (treatment) course, 3-comorbid personality disorder, 4-comorbid substance use disorder, 5-other psychiatric comorbidity, 6-somatic comorbidity, 7-maladaptive coping, 8-childhood trauma, 9-social factors, and 10-psychosocial dysfunction. Conclusions: The study findings highlight the need for a comprehensive assessment of patient indicators in determining the need for highly specialized care, and suggest that the treatment allocation of patients with MDD to highly specialized mental healthcare settings should be guided by the assessment of clinical and nonclinical patient factors.

AB - Background: Early identification of the subgroup of patients with major depressive disorder (MDD) in need of highly specialized care could enhance personalized intervention. This, in turn, may reduce the number of treatment steps needed to achieve and sustain an adequate treatment response. The aim of this study was to identify patient-related indicators that could facilitate the early identification of the subgroup of patients with MDD in need of highly specialized care. Methods: Initial patient indicators were derived from a systematic review. Subsequently, a structured conceptualization methodology known as concept mapping was employed to complement the initial list of indicators by clinical expertise and develop a consensus-based conceptual framework. Subject-matter experts were invited to participate in the subsequent steps (brainstorming, sorting, and rating) of the concept mapping process. A final concept map solution was generated using nonmetric multidimensional scaling and agglomerative hierarchical cluster analyses. Results: In total, 67 subject-matter experts participated in the concept mapping process. The final concept map revealed the following 10 major clusters of indicators: 1-depression severity, 2-onset and (treatment) course, 3-comorbid personality disorder, 4-comorbid substance use disorder, 5-other psychiatric comorbidity, 6-somatic comorbidity, 7-maladaptive coping, 8-childhood trauma, 9-social factors, and 10-psychosocial dysfunction. Conclusions: The study findings highlight the need for a comprehensive assessment of patient indicators in determining the need for highly specialized care, and suggest that the treatment allocation of patients with MDD to highly specialized mental healthcare settings should be guided by the assessment of clinical and nonclinical patient factors.

KW - depressive disorder

KW - disease management

KW - major

KW - precision medicine

KW - tertiary healthcare

UR - http://www.scopus.com/inward/record.url?scp=85044447777&partnerID=8YFLogxK

U2 - 10.1002/da.22741

DO - 10.1002/da.22741

M3 - Article

VL - 35

SP - 346

EP - 352

JO - Depression and Anxiety

JF - Depression and Anxiety

SN - 1091-4269

IS - 4

ER -