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Exploring comorbid depression and physical health trajectories : a case-based computational modeling approach

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Castellani, Brian, Griffiths, Frances, Rajaram, Rajeev and Gunn, Jane (2018) Exploring comorbid depression and physical health trajectories : a case-based computational modeling approach. Journal of Evaluation in Clinical Practice, 24 (6). pp. 1293-1309. doi:10.1111/jep.13042 ISSN 1356-1294.

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Official URL: https://doi.org/10.1111/jep.13042

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Abstract

While comorbid depression/physical health is a major clinical concern, the conventional methods of medicine make it difficult to model the complexities of this relationship. Such challenges include cataloguing multiple trends, developing multiple complex aetiological explanations, and modelling the collective large‐scale dynamics of these trends. Using a case‐based complexity approach, this study engaged in a richly described case study to demonstrate the utility of computational modelling for primary care research. N = 259 people were subsampled from the Diamond database, one of the largest primary care depression cohort studies worldwide. A global measure of depressive symptoms (PHQ‐9) and physical health (PCS‐12) were assessed at 3, 6, 9, and 12 months and then annually for a total of 7 years. Eleven trajectories and 2 large‐scale collective dynamics were identified, revealing that while depression is comorbid with poor physical health, chronic illness is often low dynamic and not always linked to depression. Also, some of the cases in the unhealthy and oscillator trends remain ill without much chance of improvement. Finally, childhood abuse, partner violence, and negative life events are greater amongst unhealthy trends. Computational modelling offers a major advance for health researchers to account for the diversity of primary care patients and for developing better prognostic models for team‐based interdisciplinary care.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Depression, Mental -- Health aspects, Primary care (Medicine)
Journal or Publication Title: Journal of Evaluation in Clinical Practice
Publisher: Wiley-Blackwell Publishing Ltd.
ISSN: 1356-1294
Official Date: December 2018
Dates:
DateEvent
December 2018Published
2 October 2018Available
20 August 2018Accepted
Volume: 24
Number: 6
Page Range: pp. 1293-1309
DOI: 10.1111/jep.13042
Status: Peer Reviewed
Publication Status: Published
Reuse Statement (publisher, data, author rights): "This is the peer reviewed version of the following article: Castellani B, Griffiths F, Rajaram R, Gunn J. Exploring comorbid depression and physical health trajectories: A case‐based computational modelling approach. J Eval Clin Pract. 2018;24:1293–1309. https://doi.org/10.1111/jep.13042, which has been published in final form at https://doi.org/10.1111/jep.13042. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions."
Access rights to Published version: Restricted or Subscription Access
Date of first compliant deposit: 29 August 2018
Date of first compliant Open Access: 18 December 2018
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
1059863National Health and Medical Research Councilhttp://dx.doi.org/10.13039/501100000925
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