Major Depressive Episodes and Random Mood

Werf, S.Y. van der; Kaptein, Kirsten I.; Jonge, Peter de; Spijker, Jan; Graaf, Ron de; Korf, Jakob

doi:10.1001/archpsyc.63.5.509

Cited by 25 publications

(19 citation statements)

References 26 publications

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“…The probability to relapse decreases over time. Recovery and relapse curves were estimated based on data from the Dutch NEMESIS study, and an Australian modelling study [19], [20]. These probability curves are presented in figure 2.…”

Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness of Opportunistic Screening and Minimal Contact Psychotherapy to Prevent Depression in Primary Care Patients

et al. 2011

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BackgroundDepression causes a large burden of disease worldwide. Effective prevention has the potential to reduce that burden considerably. This study aimed to investigate the cost-effectiveness of minimal contact psychotherapy, based on Lewinsohn's ‘Coping with depression’ course, targeted at opportunistically screened individuals with sub-threshold depression.Methods and ResultsUsing a Markov model, future health effects and costs of an intervention scenario and a current practice scenario were estimated. The time horizon was five years. Incremental cost-effectiveness ratios were expressed in euro per Disability Adjusted Life Year (DALY) averted. Probabilistic sensitivity analysis was employed to study the effect of uncertainty in the model parameters. From the health care perspective the incremental cost-effectiveness ratio was € 1,400 per DALY, and from the societal perspective the intervention was cost-saving. Although the estimated incremental costs and effects were surrounded with large uncertainty, given a willingness to pay of € 20,000 per DALY, the probability that the intervention is cost-effective was around 80%.ConclusionThis modelling study showed that opportunistic screening in primary care for sub-threshold depression in combination with minimal contact psychotherapy may be cost-effective in the prevention of major depression.

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Section: Methodsmentioning

confidence: 99%

Cost-Effectiveness of Opportunistic Screening and Minimal Contact Psychotherapy to Prevent Depression in Primary Care Patients

et al. 2011

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“…This model provides a mathematical framework for enhanced signal detection and classification and is consistent with clinical observations in untreated healthy normal subjects. Even though stochastic calculus is ubiquitous in finance and economics, it is largely untapped in the biological sciences, especially in clinical medicine [1,3,10,14,17,23,24,29,30]. The use of a qdimensional ðq -pÞ Brownian motion process to describe the driving force of the biological system could be very useful.…”

Section: Discussionmentioning

confidence: 99%

A Model for Liver Homeostasis Using Modified Mean‐Reverting Ornstein–Uhlenbeck Process

Trost

Overman

Ostroff

et al. 2008

Computational and Mathematical Methods in Medicine

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Short of a liver biopsy, hepatic disease and drug-induced liver injury are diagnosed and classified from clinical findings, especially laboratory results. It was hypothesized that a healthy hepatic dynamic equilibrium might be modelled by an Ornstein -Uhlenbeck (OU) stochastic process, which might lead to more sensitive and specific diagnostic criteria. Using pooled data from healthy volunteers in pharmaceutical clinical trials, this model was applied using maximum likelihood (ML) methods. It was found that the exponent of the autocorrelation function was proportional to the square root of time rather than time itself, as predicted by the OU model. This finding suggests a stronger autocorrelation than expected and may have important implications regarding the use of laboratory testing in clinical diagnosis, in clinical trial design, and in monitoring drug safety. Besides rejecting the OU hypothesis for liver test homeostasis, this paper presents ML estimates for the multivariate Gaussian distribution for healthy adult males. This work forms the basis for a new approach to mathematical modelling to improve both the sensitivity and specificity of clinical measurements over time.

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“…By far, most of the depressive episodes are reversible: meaning that in the general population with or without professional therapeutic interventions, about 80% recovers (Spijker et al 2002) We measured and modeled the incidence of recovery of a depressive cohort extracted from the general population with or without comorbid psychiatric or somatic pathology (van der Werf et al 2006; Kaptein et al 2007). It appeared that the rate of recovery follows an exponential time course, indicating that the probability to recover from depression is independent of the length of the depressive episode.…”

Section: Causality and The Brainmentioning

confidence: 99%

“…The model showed that the 2-week criterion of the DSM is rather arbitrary and not a characteristic (i.e. an ‘incubation period’) for major depression (van der Werf et al 2006; Kaptein et al 2007). Results on hospitalised depressed patients (e.g.…”

Section: Causality and The Brainmentioning

confidence: 99%

The possibility of evidence-based psychiatry: depression as a case

et al. 2010

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Considering psychiatry as a medical discipline, a diagnosis identifying a disorder should lead to an effective therapy. Such presumed causality is the basis of evidence-based psychiatry. We examined the strengths and weaknesses of research onto the causality of relationship between diagnosis and therapy of major depressive disorder and suggest what could be done to strengthen eventual claims on causality. Four obstacles for a rational evidence-based psychiatry were recognised. First, current classification systems are scientifically nonfalsifiable. Second, cerebral processes are—at least to some extent—nondeterministic, i.e. they are random, stochastic and/or chaotic. Third, the vague or lack of relationship between therapeutic regimens and suspected pathogenesis. Fourth, the inadequacy of tools to diagnose and delineate a functional disorder. We suggest a strategy to identify diagnostic prototypes that are characterised by a limited number of parameters (symptoms, markers and other characteristics). A prototypical diagnosis that may either support or reject particular elements of current diagnostic systems. Nevertheless, one faces the possibility that psychiatry will remain a relatively weak evidence-based medical discipline.

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Major Depressive Episodes and Random Mood

Cited by 25 publications

References 26 publications

Cost-Effectiveness of Opportunistic Screening and Minimal Contact Psychotherapy to Prevent Depression in Primary Care Patients

Cost-Effectiveness of Opportunistic Screening and Minimal Contact Psychotherapy to Prevent Depression in Primary Care Patients

A Model for Liver Homeostasis Using Modified Mean‐Reverting Ornstein–Uhlenbeck Process

The possibility of evidence-based psychiatry: depression as a case

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