Understanding and predicting prognosis for adults with depression (360G-Wellcome-201292_Z_16_Z)

Depression is the most burdensome disease world-wide in terms of years of life lost to disability. Approximately 90% of depressed patients receiving psychological therapies in the UK are treated in Improving Access to Psychological Therapies (IAPT) services. Treatment outcomes vary between and within IAPT services, with between 24-71% of patients recovering after treatment, a large proportion improve without fully recovering, but a sizeable number do not improve at all or deteriorate while receiving treatment. This project aims to develop an algorithm that can predict prognosis for patients referred to IAPT services with depression. This is important because we are unable to determine what outcome a depressed patient referred to any given IAPT service will have, or account for the variability in outcomes between IAPT services. Predictions of outcome can inform decisions on whether or not a patient should start therapy, particularly for those most likely to not improve or deteriorate during treatment; help commissioners plan for the costs of treatment therefore saving the health service money, and compare between services while accounting for area-level differences and differences in the characteristics of referred patients; and allow services to focus resources on those likely to improve with treatment, potentially improving outcomes.