Clinical utility of family history of depression for prognosis of adolescent depression severity and duration assessed with predictive modeling

Lisa S Gorham, Neda Sadeghi, Lillian Eisner, Jeremy Taigman, Katherine Haynes, Karen Qi, Christopher C Camp, Payton Fors, Diana Rodriguez, Jerry McGuire, Erin Garth, Chana Engel, Mollie Davis, Kenneth Towbin, Argyris Stringaris, Dylan M Nielson, Lisa S Gorham, Neda Sadeghi, Lillian Eisner, Jeremy Taigman, Katherine Haynes, Karen Qi, Christopher C Camp, Payton Fors, Diana Rodriguez, Jerry McGuire, Erin Garth, Chana Engel, Mollie Davis, Kenneth Towbin, Argyris Stringaris, Dylan M Nielson

Abstract

Background: Family history of depression (FHD) is a known risk factor for the new onset of depression. However, it is unclear if FHD is clinically useful for prognosis in adolescents with current, ongoing, or past depression. This preregistered study uses a longitudinal, multi-informant design to examine whether a child's FHD adds information about future depressive episodes and depression severity applying state-of-the-art predictive out-of-sample methodology.

Methods: We examined data in adolescents with current or past depression (age 11-17 years) from the National Institute of Mental Health Characterization and Treatment of Adolescent Depression (CAT-D) study. We asked whether a history of depression in a first-degree relative was predictive of depressive episode duration (72 participants) and future depressive symptom severity in probands (129 participants, 1,439 total assessments).

Results: Family history of depression, while statistically associated with time spent depressed, did not improve predictions of time spent depressed, nor did it improve models of change in depression severity measured by self- or parent-report.

Conclusions: Family history of depression does not improve the prediction of the course of depression in adolescents already diagnosed with depression. The difference between statistical association and predictive models highlights the importance of assessing predictive performance when evaluating questions of clinical utility.

Trial registration: ClinicalTrials.gov NCT03388606.

Keywords: Depression; adolescence; family history; longitudinal studies.

Published 2021. This article is a U.S. Government work and is in the public domain in the USA. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

Figures

Figure 1
Figure 1
The top panel (A) shows the RMSE for each model along with bootstrap 99.9% confidence intervals. The lower panel (B) shows comparisons of interest between models in A. Each dot represents the mean difference in RMSE, while the error bars represent 99.9% confidence intervals. Two weeks of depression is the defined minimum length for an episode of depression, and half of this value is also shown. In no case does Family History improve the RMSE by more than 4 weeks (Null vs. MFQ, and MFQ vs. MFQ + FH)
Figure 2
Figure 2
The top panel (A) shows the RMSE for each model along with bootstrap 99.9% confidence intervals. The lower panel (B) shows comparisons of interest between models in A. Each dot represents the mean difference in RMSE, while the error bars represent 99.9% confidence intervals. Six points on the MFQ is the minimum clinical difference, and half of this value is also shown

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