Our new #OA paper: the importance of transdiagnostic symptom level assessment to understanding prognosis for depressed adults. Combined IPD from six RCTs (n = 2858) https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-01971-0">https://bmcmedicine.biomedcentral.com/articles/...

co-authors: @J_EJ_Buckman @EikoFried @DepressionLab @RobertDeRubeis @steven_hollon @SimonGilbody @DavidAKesslerMD @GlynLewis9 @ERWatkins2 & others not on twitter

Highlights: We compared individual items and sum scores models predicting outcomes at three post-intervention time points. This only showed a difference at 9 to 12 months.

We estimated the contribution of each item to the outcome prediction using Shapley Additive exPlanations (SHAP). Pessimism was consistently the most important predictor.

Finally, network modelling revealed 3 communities, primary bridge symptoms (sadness; pessimism; and indecision) and most central were sadness and failure/worthless. No overall difference in networks between remitters and persisters.

The study highlights the importance of assessing transdiagnostic symptoms. Valuable information about prognosis can be gained by understanding the interrelations between individual symptoms, info not available when considering sum scores or baseline symptom severity alone.