A new universal test to predict the risk of someone succumbing to major
depression has been developed by UCL (University College London)
researchers. The online tool, predictD, could eventually be used by family
doctors and local clinics to identify those at risk of depression for whom
prevention might be most useful.
The risk algorithm, developed by a team led by UCL Professors Michael King
and Irwin Nazareth, was tested in 6,000 people visiting their family
doctor in six countries in Europe (UK, Spain, Portugal, the Netherlands,
Slovenia and Estonia). Its accuracy was also tested in nearly 3,000 GP
attendees in a further country, Buy levitra pills Chile, in South America. The study,
published in the Archives of General Psychiatry, followed-up the
participants at six and 12 months. The team modelled their approach on
risk indices for heart disease, which provide a percentage risk estimate
over a given time period. The algorithm was as accurate at predicting
future episodes of depression as similar instruments developed in Europe
to predict future risk of heart problems.
A website has been set up for the risk algorithm, at

Further testing of the tool as an early detector of depression is planned
in randomised trials of prevention in Europe. The team are also exploring
the feasibility of using the instrument in China, with plans to set up a
study on the prediction of depression in a Chinese community setting.
This would be the first ever research initiative of its kind within Asia.
Professor Michael King, UCL Department of Mental Health Sciences, says:
"Depression is a common problem throughout the world, but although we know
how to treat it, we know very little about how to prevent its onset. We
have ways of predicting the onset of heart disease or stroke, but none for
predicting people’s risk of major depression. Our study is one of the
first to develop a risk algorithm for just this purpose."
"Risk tools such as ours are needed to focus more effort on preventing
depression. For example, people identified as at risk by an online tool
could be flagged on a GP’s computer. Recognition of those at risk could
help with watchful waiting or active support, such as restarting treatment
in patients with a history of depression. Patients could also be advised
on the nature of depression or on cognitive behaviour therapies to help
reduce their risk of developing major depression."
"Major depression is now a leading cause of illness and disability
world-wide and reducing its prevalence is one of the greatest public
health challenges of the twenty-first century. Depression will rank
second to cardiovascular disease as a global cause of disability by 2020.
Up to a quarter of people who visit their doctor experience major
depression, with relapses frequently occurring for up to 10 years."
"The next stage of our research will be to establish how GPs could use our
tool to help prevent the onset of depression. We are hoping to run a
large-scale trial to explore the tool’s use in prevention."
Notes
1. ‘Development and validation of an international risk prediction
algorithm for episodes of major depression in general practice attendees’,
by Michael King et al., is published in the December issue of the Archives
of General Psychiatry at Copies of the
paper can also be obtained from the UCL Media Relations Office.
2. This study was funded by the European Commission.
University College London
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