Toward an Extended Definition of Major Depressive Disorder Symptomatology: Digital Assessment and Cross-validation Study.
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Authors
Publication Date
2021-10-28Journal Title
JMIR Form Res
ISSN
2561-326X
Publisher
JMIR Publications Inc.
Volume
5
Issue
10
Language
eng
Type
Article
This Version
VoR
Metadata
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Martin-Key, N. A., Mirea, D., Olmert, T., Cooper, J., Han, S. Y. S., Barton-Owen, G., Farrag, L., et al. (2021). Toward an Extended Definition of Major Depressive Disorder Symptomatology: Digital Assessment and Cross-validation Study.. JMIR Form Res, 5 (10) https://doi.org/10.2196/27908
Abstract
BACKGROUND: Diagnosing major depressive disorder (MDD) is challenging, with diagnostic manuals failing to capture the wide range of clinical symptoms that are endorsed by individuals with this condition. OBJECTIVE: This study aims to provide evidence for an extended definition of MDD symptomatology. METHODS: Symptom data were collected via a digital assessment developed for a delta study. Random forest classification with nested cross-validation was used to distinguish between individuals with MDD and those with subthreshold symptomatology of the disorder using disorder-specific symptoms and transdiagnostic symptoms. The diagnostic performance of the Patient Health Questionnaire-9 was also examined. RESULTS: A depression-specific model demonstrated good predictive performance when distinguishing between individuals with MDD (n=64) and those with subthreshold depression (n=140) (area under the receiver operating characteristic curve=0.89; sensitivity=82.4%; specificity=81.3%; accuracy=81.6%). The inclusion of transdiagnostic symptoms of psychopathology, including symptoms of depression, generalized anxiety disorder, insomnia, emotional instability, and panic disorder, significantly improved the model performance (area under the receiver operating characteristic curve=0.95; sensitivity=86.5%; specificity=90.8%; accuracy=89.5%). The Patient Health Questionnaire-9 was excellent at identifying MDD but overdiagnosed the condition (sensitivity=92.2%; specificity=54.3%; accuracy=66.2%). CONCLUSIONS: Our findings are in line with the notion that current diagnostic practices may present an overly narrow conception of mental health. Furthermore, our study provides proof-of-concept support for the clinical utility of a digital assessment to inform clinical decision-making in the evaluation of MDD.
Keywords
Mobile phone, Major Depressive Disorder, Digital Assessment, Digital Mental Health, Subthreshold Depression, Transdiagnostic Symptoms
Identifiers
PMC8587324, 34709182
External DOI: https://doi.org/10.2196/27908
This record's URL: https://www.repository.cam.ac.uk/handle/1810/332235
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