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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 (In Press)
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Official URL: https://doi.org/10.1111/jep.13042
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 | ||||||||
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| Subjects: | R Medicine > RC Internal medicine | ||||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| 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: |
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| Date of first compliant deposit: | 29 August 2018 | ||||||||
| Volume: | 24 | ||||||||
| Number: | 6 | ||||||||
| Page Range: | pp. 1293-1309 | ||||||||
| DOI: | 10.1111/jep.13042 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | In Press | ||||||||
| Publisher Statement: | "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 | ||||||||
| RIOXX Funder/Project Grant: |
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