Understanding personalized dynamics to inform precision medicine: a dynamic time warp analysis of 255 depressed inpatients

Hebbrecht, Kaat; Stuivenga, Mirella; Birkenhäger, Tom K.; Morrens, Manuel; Fried, Eiko I.; Sabbe, Bernard; Giltay, Erik J.

doi:10.1186/s12916-020-01867-5

Cited by 39 publications

(38 citation statements)

References 53 publications

(76 reference statements)

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“…Some specific findings are worth discussing in some detail. The association between depressed mood and anhedonia was consistent with other findings 45 , representing core symptoms of depression 46 , and excessive and uncontrollable worry as a transdiagnostic process (i.e. repetitive negative thinking) 47 , 48 .…”

Section: Discussionsupporting

confidence: 90%

Transdiagnostic symptom dynamics during psychotherapy

O’Driscoll

Epskamp

Fried

et al. 2022

Sci Rep

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Psychotherapy is an effective treatment for many common mental health problems, but the mechanisms of action and processes of change are unclear, perhaps driven by the focus on a single diagnosis which does not reflect the heterogeneous symptom experiences of many patients. The objective of this study was to better understand therapeutic change, by illustrating how symptoms evolve and interact during psychotherapy. Data from 113,608 patients from psychological therapy services who completed depression and anxiety symptom measures across three to six therapy sessions were analysed. A panel graphical vector-autoregression model was estimated in a model development sample (N = 68,165) and generalizability was tested in a confirmatory model, fitted to a separate (hold-out) sample of patients (N = 45,443). The model displayed an excellent fit and replicated in the confirmatory holdout sample. First, we found that nearly all symptoms were statistically related to each other (i.e. dense connectivity), indicating that no one symptom or association drives change. Second, the structure of symptom interrelations which emerged did not change across sessions. These findings provide a dynamic view of the process of symptom change during psychotherapy and give rise to several causal hypotheses relating to structure, mechanism, and process.

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Section: Discussionsupporting

confidence: 90%

Transdiagnostic symptom dynamics during psychotherapy

O’Driscoll

Epskamp

Fried

et al. 2022

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…Some specific findings are worth discussing in some detail. The association between depressed mood and anhedonia was consistent with other findings 44 , representing core symptoms of depression 45 , and excessive and uncontrollable worry as a transdiagnostic process (i.e. repetitive negative thinking) 46,47 .…”

Section: Discussionsupporting

confidence: 90%

Transdiagnostic Symptom Dynamics during Psychotherapy

O’Driscoll¹,

Epskamp²,

Fried³

et al. 2022

Preprint

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Psychotherapy is an effective treatment for many mental health problems, but the mechanisms of action and processes of change are unclear, perhaps driven by the focus on a single diagnosis which does not reflect the heterogeneous symptom experiences of many patients. The objective of this study was to better understand therapeutic change, by illustrating how symptoms evolve and interact during psychotherapy. Data from 113,608 patients from psychological therapy services who completed depression and anxiety symptom measures across six therapy sessions were analysed. A panel graphical vector-autoregression model was estimated in a model development sample (N=68,165) and generalizability was tested in a confirmatory model, fitted to a separate (hold-out) sample of patients (N=45,443). The model displayed an excellent fit and replicated in the confirmatory holdout sample. First, we found that nearly all symptoms were statistically related to each other (i.e. dense connectivity), indicating that no one symptom or association drives change. Second, the structure of symptom interrelations which emerged did not change across sessions. These findings provide a dynamic view of the process of symptom change during psychotherapy and give rise to several causal hypotheses relating to structure, mechanism, and process.

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“…One interesting result is the heterogeneity across participants in (univariate) autoregressive effects for the majority of EMA variables. Idiographic follow-up work will be important to understand how time series of mental health data, and their relations, differ across people (Fisher et al, 2018;Fried & Cramer, 2017;Hebbrecht et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Mental Health and Social Contact During the COVID-19 Pandemic: An Ecological Momentary Assessment Study

Fried

Papanikolaou

Epskamp

2021

Clinical Psychological Science

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For many students, the COVID-19 pandemic caused once-in-a-lifetime disruptions of daily life. In March 2020, during the beginning of the outbreak in the Netherlands, we used ecological momentary assessment to follow 80 undergraduate students four times per day for 14 days to assess mental health, social contact, and COVID-19-related variables. Despite rapidly increasing rates of infections and deaths, we observed decreases in anxiety, loneliness, and COVID-19-related concerns, especially in the first few days. Other mental health variables, such as stress levels, remained stable, whereas depressive symptoms increased. Despite social-distancing measures implemented by the Dutch government halfway through our study, students showed no changes in the frequency of in-person social activities. Dynamic network models identified potential vicious cycles between mental health variables and being alone, which predicted concerns about COVID-19 and was followed by further mental health problems. Findings and implications are discussed in detail.

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Understanding personalized dynamics to inform precision medicine: a dynamic time warp analysis of 255 depressed inpatients

Cited by 39 publications

References 53 publications

Transdiagnostic symptom dynamics during psychotherapy

Transdiagnostic symptom dynamics during psychotherapy

Transdiagnostic Symptom Dynamics during Psychotherapy

Mental Health and Social Contact During the COVID-19 Pandemic: An Ecological Momentary Assessment Study

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