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dc.contributor.authorBuckman, JEJ
dc.contributor.authorSaunders, R
dc.contributor.authorArundell, L-L
dc.contributor.authorOshinowo, ID
dc.contributor.authorCohen, ZD
dc.contributor.authorO'Driscoll, C
dc.contributor.authorBarnett, P
dc.contributor.authorStott, J
dc.contributor.authorAmbler, G
dc.contributor.authorGilbody, S
dc.contributor.authorHollon, SD
dc.contributor.authorKendrick, T
dc.contributor.authorWatkins, E
dc.contributor.authorEley, TC
dc.contributor.authorSkelton, M
dc.contributor.authorWiles, N
dc.contributor.authorKessler, D
dc.contributor.authorDeRubeis, RJ
dc.contributor.authorLewis, G
dc.contributor.authorPilling, S
dc.date.accessioned2022-12-21T13:40:51Z
dc.date.issued2021-12-17
dc.date.updated2022-12-21T12:26:10Z
dc.description.abstractOBJECTIVE: To investigate associations between major life events and prognosis independent of treatment type: (1) after adjusting for clinical prognostic factors and socio-demographics; (2) amongst patients with depressive episodes at least six-months long; and (3) patients with a first life-time depressive episode. METHODS: Six RCTs of adults seeking treatment for depression in primary care met eligibility criteria, individual patient data (IPD) were collated from all six (n = 2858). Participants were randomized to any treatment and completed the same baseline assessment of life events, demographics and clinical prognostic factors. Two-stage random effects meta-analyses were conducted. RESULTS: Reporting any major life events was associated with poorer prognosis regardless of treatment type. Controlling for baseline clinical factors, socio-demographics and social support resulted in minimal residual evidence of associations between life events and treatment prognosis. However, removing factors that might mediate the relationships between life events and outcomes reporting: arguments/disputes, problem debt, violent crime, losing one's job, and three or more life events were associated with considerably worse prognoses (percentage difference in 3-4 months depressive symptoms compared to no reported life events =30.3%(95%CI: 18.4-43.3)). CONCLUSIONS: Assessing for clinical prognostic factors, social support, and socio-demographics is likely to be more informative for prognosis than assessing self-reported recent major life events. However, clinicians might find it useful to ask about such events, and if they are still affecting the patient, consider interventions to tackle problems related to those events (e.g. employment support, mediation, or debt advice). Further investigations of the efficacy of such interventions will be important.en_GB
dc.description.sponsorshipWellcome Trusten_GB
dc.description.sponsorshipMQ Foundationen_GB
dc.description.sponsorshipAlzheimer’s Societyen_GB
dc.description.sponsorshipNational Institute of Health Researchen_GB
dc.description.sponsorshipNIHR University College London Hospitals Biomedical Research Centreen_GB
dc.description.sponsorshipUniversity College Londonen_GB
dc.description.sponsorshipUniversity of Southamptonen_GB
dc.description.sponsorshipUniversity of Exeteren_GB
dc.description.sponsorshipUniversity of Yorken_GB
dc.description.sponsorshipNIHR Biomedical Research Centre at the University Hospitals Bristol and Weston NHS Foundation Trusten_GB
dc.description.sponsorshipUniversity of Bristolen_GB
dc.description.sponsorshipNational Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trusten_GB
dc.format.extent298-308
dc.format.mediumPrint-Electronic
dc.identifier.citationVol. 299, pp. 298-308en_GB
dc.identifier.doihttps://doi.org/10.1016/j.jad.2021.12.030
dc.identifier.grantnumber20129/Z/16/Zen_GB
dc.identifier.grantnumberMQDS16/72en_GB
dc.identifier.grantnumberAS-PG-18–013en_GB
dc.identifier.urihttp://hdl.handle.net/10871/132073
dc.identifierORCID: 0000-0002-2432-5577 (Watkins, Edward)
dc.language.isoenen_GB
dc.publisherElsevieren_GB
dc.relation.urlhttps://www.ncbi.nlm.nih.gov/pubmed/34920035en_GB
dc.rights© 2021 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).en_GB
dc.subjectDepressionen_GB
dc.subjectIndividual patient data meta-analysisen_GB
dc.subjectStressful life eventsen_GB
dc.subjectSystematic reviewen_GB
dc.subjectTreatment outcomeen_GB
dc.titleLife events and treatment prognosis for depression: A systematic review and individual patient data meta-analysis.en_GB
dc.typeArticleen_GB
dc.date.available2022-12-21T13:40:51Z
dc.identifier.issn0165-0327
exeter.place-of-publicationNetherlands
dc.descriptionThis is the final version. Available from Elsevier via the DOI in this record. en_GB
dc.descriptionData availability: Requests for sharing of the IPD used in this study can be made to the corresponding author, any sharing of data will be subject to obtaining appropriate agreements from the chief investigators or data custodians for each individual trial dataset used here.en_GB
dc.identifier.eissn1573-2517
dc.identifier.journalJournal of Affective Disordersen_GB
dc.relation.ispartofJ Affect Disord, 299
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_GB
dcterms.dateAccepted2021-12-12
dc.rights.licenseCC BY
rioxxterms.versionVoRen_GB
rioxxterms.licenseref.startdate2021-12-17
rioxxterms.typeJournal Article/Reviewen_GB
refterms.dateFCD2022-12-21T13:32:26Z
refterms.versionFCDVoR
refterms.dateFOA2022-12-21T13:40:51Z
refterms.panelAen_GB
refterms.dateFirstOnline2021-12-17


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© 2021 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Except where otherwise noted, this item's licence is described as © 2021 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).