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Exploring comorbid depression and physical health trajectories : a case-based computational modelling approach.

Castellani, Brian and Griffiths, Frances and Rajaram, Rajeev and Gunn, Jane (2018) 'Exploring comorbid depression and physical health trajectories : a case-based computational modelling approach.', Journal of evaluation in clinical practice., 24 (6). pp. 1293-1309.


While comorbid depression/physical health is a major clinical concern, the conventional methods of medicine make it difficult to model the complexities of this relationship. Such challenges include cataloguing multiple trends, developing multiple complex aetiological explanations, and modelling the collective large‐scale dynamics of these trends. Using a case‐based complexity approach, this study engaged in a richly described case study to demonstrate the utility of computational modelling for primary care research. N = 259 people were subsampled from the Diamond database, one of the largest primary care depression cohort studies worldwide. A global measure of depressive symptoms (PHQ‐9) and physical health (PCS‐12) were assessed at 3, 6, 9, and 12 months and then annually for a total of 7 years. Eleven trajectories and 2 large‐scale collective dynamics were identified, revealing that while depression is comorbid with poor physical health, chronic illness is often low dynamic and not always linked to depression. Also, some of the cases in the unhealthy and oscillator trends remain ill without much chance of improvement. Finally, childhood abuse, partner violence, and negative life events are greater amongst unhealthy trends. Computational modelling offers a major advance for health researchers to account for the diversity of primary care patients and for developing better prognostic models for team‐based interdisciplinary care.

Item Type:Article
Full text:(AM) Accepted Manuscript
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Publisher statement:This is the accepted version of the following article: Castellani, Brian, Griffiths, Frances, Rajaram, Rajeev & Gunn, Jane (2018). Exploring comorbid depression and physical health trajectories: A case-based computational modelling approach. Journal of Evaluation in Clinical Practice 24(6): 1293-1309, which has been published in final form at This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Date accepted:20 August 2018
Date deposited:11 December 2018
Date of first online publication:02 October 2018
Date first made open access:02 October 2019

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