The decision tool unipolar depression (DTUD): a new measure to facilitate the early identification of patients with major depressive disorder in need of highly specialized care

Autor: van Krugten, Frédérique C. W., Goorden, Maartje, van Balkom, Anton J. L. M., van Oppen, Patricia, Ruhé, Henricus G., van Schaik, Digna J. F., Brouwer, Werner B. F., Hakkaart-van Roijen, Leona, van Balkom, A. J. L. M., Bockting, C. L. H., van den Boogaard, T. M., van Schaik, D. J. F., van Oppen, P., Ruhé, H. G., Peeters, F. P. M. L., Spijker, J., Huijs, P. A. J. M., Loo, M. A. J. M., van, H. L., Broekema, W. J., van't Thijs-van't Hoog, A. E.
Přispěvatelé: Health Technology Assessment (HTA), Applied Economics, APH - Mental Health, Psychiatry, Adult Psychiatry, ANS - Mood, Anxiety, Psychosis, Stress & Sleep, APH - Personalized Medicine, APH - Digital Health
Rok vydání: 2019
Předmět:
Adult
Male
Adolescent
Psychometrics
lcsh:RC435-571
Clinical Decision-Making
Youden's J statistic
Stress-related disorders Donders Center for Medical Neuroscience [Radboudumc 13]
Major depressive disorder
Treatment stratification
Early intervention
Experimental Psychopathology and Treatment
Young Adult
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
0302 clinical medicine
lcsh:Psychiatry
Validation
Tertiary healthcare
Criterion validity
Humans
Medicine
030212 general & internal medicine
Reliability (statistics)
Depression (differential diagnoses)
Aged
Netherlands
Psychiatric Status Rating Scales
Depressive Disorder
Depressive Disorder
Major
Measurement
Receiver operating characteristic
Depression
business.industry
Reproducibility of Results
Middle Aged
medicine.disease
3. Good health
030227 psychiatry
Psychiatry and Mental health
Cross-Sectional Studies
Treatment Outcome
Convergent validity
Female
business
Research Article
Clinical psychology
Zdroj: BMC Psychiatry, 19
BMC Psychiatry, Vol 19, Iss 1, Pp 1-9 (2019)
BMC Psychiatry, 19:179. BioMed Central Ltd.
BMC Psychiatry
BMC Psychiatry, 19(1). BioMed Central
van Krugten, F C W, Goorden, M, van Balkom, A J L M, van Oppen, P, van Schaik, D J F, Brouwer, W B F, Hakkaart-van Roijen, L, Decision Tool Unipolar Depression Consortium, Bockting, C L H, van den Boogaard, T M, Ruhe, H G, Peeters, F P M L, Spijker, J, Huijs, P A J M, Loo, M A J M, Van, H L, Broekema, W J & van't Thijs-van't Hoog, A E 2019, ' The decision tool unipolar depression (DTUD) : a new measure to facilitate the early identification of patients with major depressive disorder in need of highly specialized care ', BMC Psychiatry, vol. 19, no. 1, pp. 179 . https://doi.org/10.1186/s12888-019-2165-9
BMC psychiatry, 19(1):179. BioMed Central
ISSN: 1471-244X
DOI: 10.1186/s12888-019-2165-9
Popis: Background Selection of the optimal initial treatment in patients with major depressive disorder (MDD) in need of highly specialized care has the potential to benefit treatment outcomes and cost-effectiveness of treatment strategies. However, to date, there is a paucity of measures that could guide the selection of the initial treatment, in particular to indicate which patients with MDD are in need of highly specialized care. Recognizing this gap, this paper reports on the development and psychometric evaluation of the Decision Tool Unipolar Depression (DTUD), aimed to facilitate the early identification of patients with MDD in need of highly specialized care. Methods The DTUD was developed using a mixed-methods approach, consisting of a systematic review and a concept mapping study. To evaluate the psychometric features of the DTUD, a cross-sectional multicenter study was conducted. A total of 243 patients with MDD were evaluated with the DTUD. Feasibility was operationalized as the time required to complete the DTUD and the content clarity of the DTUD. Inter-rater reliability was evaluated using Krippendorf’s alpha. The Maudsley Staging Method (MSM) and the Dutch Measure for quantification of Treatment Resistance in Depression (DM-TRD) were administered to assess the convergent validity. A receiver operator characteristic curve was generated to evaluate the criterion validity and establish the optimal cut-off value. Results The mean administration time was 4.49 min (SD = 2.71), and the content of the total DTUD was judged as clear in 94.7% of the evaluations. Inter-rater reliability values ranged from 0.69 to 0.91. Higher scores on the DTUD were associated with higher scores on the MSM (rs = 0.47) and DM-TRD (rs = 0.53). Based on the maximum Youden index (0.494), maximum discrimination was reached at a cut-off score of ≥5 (sensitivity 67%, specificity 83%). Conclusion The DTUD demonstrated to be a tool with solid psychometric properties and, therefore, is a promising measure for the early identification of patients with MDD in need of highly specialized care. Use of the DTUD has the potential to facilitate the selection and initiation of the optimal initial treatment in patients with MDD, which in turn may improve the clinical effectiveness and cost-effectiveness of treatment strategies. Electronic supplementary material The online version of this article (10.1186/s12888-019-2165-9) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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