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dc.contributor.authorMartin-Key, Nayra A
dc.contributor.authorMirea, Dan-Mircea
dc.contributor.authorOlmert, Tony
dc.contributor.authorCooper, Jason
dc.contributor.authorHan, Sung Yeon Sarah
dc.contributor.authorBarton-Owen, Giles
dc.contributor.authorFarrag, Lynn
dc.contributor.authorBell, Emily
dc.contributor.authorEljasz, Pawel
dc.contributor.authorCowell, Daniel
dc.contributor.authorTomasik, Jakub
dc.contributor.authorBahn, Sabine
dc.description.abstractBACKGROUND: 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.
dc.publisherJMIR Publications Inc.
dc.rightsAttribution 4.0 International
dc.sourceessn: 2561-326X
dc.sourcenlmid: 101726394
dc.subjectdigital assessment
dc.subjectdigital mental health
dc.subjectmajor depressive disorder
dc.subjectmobile phone
dc.subjectsubthreshold depression, transdiagnostic symptoms
dc.titleToward an Extended Definition of Major Depressive Disorder Symptomatology: Digital Assessment and Cross-validation Study.
prism.publicationNameJMIR Form Res
dc.contributor.orcidMartin-Key, Nayra A [0000-0002-9731-3809]
dc.contributor.orcidMirea, Dan-Mircea [0000-0002-4349-7059]
dc.contributor.orcidOlmert, Tony [0000-0003-4641-6442]
dc.contributor.orcidCooper, Jason [0000-0002-2459-5286]
dc.contributor.orcidHan, Sung Yeon Sarah [0000-0002-1459-2516]
dc.contributor.orcidBarton-Owen, Giles [0000-0002-7552-1295]
dc.contributor.orcidFarrag, Lynn [0000-0002-5045-5308]
dc.contributor.orcidBell, Emily [0000-0003-2037-3093]
dc.contributor.orcidEljasz, Pawel [0000-0002-0592-3934]
dc.contributor.orcidCowell, Daniel [0000-0001-6061-3544]
dc.contributor.orcidTomasik, Jakub [0000-0002-2127-4487]
dc.contributor.orcidBahn, Sabine [0000-0003-4690-6302]

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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International