Determinants Associated with Improvement in Depression Scores in a Cohort of Adult Patients Followed over 1 Year
Background The prevalence of depression in Canada as reported in 2015 was 4.7%. Major Depressive Disorders are the second leading cause of global disability. The mainstay of therapy for depression continues to be psychopharmacology. The purpose of my study was to ascertain determinants associated with change in depression scores over one year in a cohort of adults. Methods The study was based on the data collected by The Neural Health Project (NHP) and was based on improvement in Beck Depression Inventory-II scores over a 12-month period (completed scores were available for 90 participants, n=90). There were two arms, standard medical care arm and integrative medical care (intervention) arm. Percentage change between baseline scores and those at one year were calculated based on Beck scores. A ≥ 30 % percentage change in Beck scores was viewed as an improvement in depression. Binomial logistic regression was performed to determine the effects of sex, treatment group, age as a category, and happiness, on the likelihood of predicting improvement in Beck scores over a 12-month period. Results Beck scores were available for 93 participants at visit 1, and for 90 at the final visit. Mean difference (±SE) in Beck scores over 12 months for standard medical care was 3.63(±1.105) and for integrative medical care 8.13(±1.094) (p=0.005). Improvement in depression symptoms based on the percentage change in Beck scores was 16.89 (±5.421) for standard medical care and 34.07(±8.622) for integrative medical care (p=0.005). The logistic regression model was statistically significant with p=0.018. The model correctly classified 65.2 % of the cases. Sensitivity was 76.1%, specificity was 53.5%, positive predictive value was 63.6% and negative predictive value was 67.67%. Of the 4 predictor variables, only study group was statistically significant at p=0.006. Those in the integrative medical care group were 3.64 times more likely to show ≥ 30% improvement in Beck scores than those in the standard medical care group. Conclusion Integrative medical care was superior to standard medical care in the treatment of adult depression. This was the first study of its kind in Canada. More studies are suggested to explore these findings with a larger sample, and in multi-center trials.
Integrative medical care, Depression, Interventional, Beck Depression Inventory-II, Quasi-experimental design
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