Treatment profiles and trajectories surrounding the diagnosis of major depressive disorder: a research protocol for a Danish register-based study. [version 1; peer review: 1 approved]

Background: Major depressive disorder (MDD) is a prevalent illness that causes significant suffering and expenses at the personal and societal levels. The disorder is subject to heterogeneity reflected by diverse clinical phenotypes and assorted responses to treatment. Research on MDD treatments hav...

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Hauptverfasser: Herold Jeberg, Pernille, Overgaard Nielsen, Anne Marije Christina, Osler, Merete, Kim Wirum-Andersen, Marie, Jacobsen, Ramune, Almarsdóttir, Anna Birna, Jarlov Jensen, Kristoffer, Petersen, Janne
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Veröffentlicht: 2022
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ISSN:2046-1402, 2046-1402
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Abstract Background: Major depressive disorder (MDD) is a prevalent illness that causes significant suffering and expenses at the personal and societal levels. The disorder is subject to heterogeneity reflected by diverse clinical phenotypes and assorted responses to treatment. Research on MDD treatments have focused on one treatment at a time, however many patients receive several different treatments. Considering the number of available treatment options, we hypothesize that it is possible to identify clinically meaningful groups of patients based on their psychiatric treatment. The objective of this study is therefore to identify psychiatric treatment profiles and trajectories of patients with major depressive disorder and, for the identified profiles and trajectories, to assess clinical and sociodemographic factors. Method: The study will be a population-based register study of patients with major depressive disorder in the Danish National Patient Register between 2011 and 2015. Using latent class analyses, we will identify homogenous groups of patients based on their psychiatric treatment patterns. These patterns constitute psychiatric treatment profiles which will be identified at six time-intervals, from 1.5 years before to 3 years after diagnosis of major depressive disorder. By cross-tabulating the identified treatment profiles, we will establish psychiatric treatment trajectories. Patients sharing profiles and trajectories will be characterized. Discussion: Identification of psychiatric treatment profiles and trajectories based on an unsupervised learning algorithm have the potential to reveal hidden patterns of psychiatric treatment. This will potentially pave the way for future studies of treatment combinations and a larger insight into the different courses of treatment. Furthermore, the assessment of clinical and sociodemographic factors may indicate different patient characteristics across treatment profiles and trajectories.
AbstractList Background: Major depressive disorder (MDD) is a prevalent illness that causes significant suffering and expenses at the personal and societal levels. The disorder is subject to heterogeneity reflected by diverse clinical phenotypes and assorted responses to treatment. Research on MDD treatments have focused on one treatment at a time, however many patients receive several different treatments. Considering the number of available treatment options, we hypothesize that it is possible to identify clinically meaningful groups of patients based on their psychiatric treatment. The objective of this study is therefore to identify psychiatric treatment profiles and trajectories of patients with major depressive disorder and, for the identified profiles and trajectories, to assess clinical and sociodemographic factors. Method: The study will be a population-based register study of patients with major depressive disorder in the Danish National Patient Register between 2011 and 2015. Using latent class analyses, we will identify homogenous groups of patients based on their psychiatric treatment patterns. These patterns constitute psychiatric treatment profiles which will be identified at six time-intervals, from 1.5 years before to 3 years after diagnosis of major depressive disorder. By cross-tabulating the identified treatment profiles, we will establish psychiatric treatment trajectories. Patients sharing profiles and trajectories will be characterized. Discussion: Identification of psychiatric treatment profiles and trajectories based on an unsupervised learning algorithm have the potential to reveal hidden patterns of psychiatric treatment. This will potentially pave the way for future studies of treatment combinations and a larger insight into the different courses of treatment. Furthermore, the assessment of clinical and sociodemographic factors may indicate different patient characteristics across treatment profiles and trajectories.
Background: Major depressive disorder (MDD) is a prevalent illness that causes significant suffering and expenses at the personal and societal levels. The disorder is subject to heterogeneity reflected by diverse clinical phenotypes and assorted responses to treatment. Research on MDD treatments have focused on one treatment at a time, however many patients receive several different treatments. Considering the number of available treatment options, we hypothesize that it is possible to identify clinically meaningful groups of patients based on their psychiatric treatment. The objective of this study is therefore to identify psychiatric treatment profiles and trajectories of patients with major depressive disorder and, for the identified profiles and trajectories, to assess clinical and sociodemographic factors. Method: The study will be a population-based register study of patients with major depressive disorder in the Danish National Patient Register between 2011 and 2015. Using latent class analyses, we will identify homogenous groups of patients based on their psychiatric treatment patterns. These patterns constitute psychiatric treatment profiles which will be identified at six time-intervals, from 1.5 years before to 3 years after diagnosis of major depressive disorder. By cross-tabulating the identified treatment profiles, we will establish psychiatric treatment trajectories. Patients sharing profiles and trajectories will be characterized. Discussion: Identification of psychiatric treatment profiles and trajectories based on an unsupervised learning algorithm have the potential to reveal hidden patterns of psychiatric treatment. This will potentially pave the way for future studies of treatment combinations and a larger insight into the different courses of treatment. Furthermore, the assessment of clinical and sociodemographic factors may indicate different patient characteristics across treatment profiles and trajectories.
Author Almarsdóttir, Anna Birna
Petersen, Janne
Herold Jeberg, Pernille
Osler, Merete
Jacobsen, Ramune
Kim Wirum-Andersen, Marie
Jarlov Jensen, Kristoffer
Overgaard Nielsen, Anne Marije Christina
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  surname: Herold Jeberg
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  email: pernille.herold.jeberg@regionh.dk
  organization: Section of Social and Clinical Pharmacy, Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
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  givenname: Anne Marije Christina
  orcidid: 0000-0003-1676-3312
  surname: Overgaard Nielsen
  fullname: Overgaard Nielsen, Anne Marije Christina
  organization: Section of Social and Clinical Pharmacy, Department of Pharmacy, University of Copenhagen, Copenhagen, Denmark
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  givenname: Merete
  surname: Osler
  fullname: Osler, Merete
  organization: Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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  givenname: Marie
  surname: Kim Wirum-Andersen
  fullname: Kim Wirum-Andersen, Marie
  organization: Center for Clinical Research and Prevention, Copenhagen, Denmark
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  orcidid: 0000-0002-8142-9807
  surname: Jacobsen
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  orcidid: 0000-0002-5354-2976
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  givenname: Kristoffer
  surname: Jarlov Jensen
  fullname: Jarlov Jensen, Kristoffer
  organization: Center for Clinical Research and Prevention, Copenhagen, Denmark
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  givenname: Janne
  surname: Petersen
  fullname: Petersen, Janne
  organization: Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Copyright Copyright: © 2022 Herold Jeberg P et al.
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Keywords Denmark
treatment profile
Depression
latent class analysis
treatment trajectory
Language English
License http://creativecommons.org/licenses/by/4.0/: This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Title Treatment profiles and trajectories surrounding the diagnosis of major depressive disorder: a research protocol for a Danish register-based study. [version 1; peer review: 1 approved]
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