Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Algorithms Help Predict Patients at Risk for MDD

Multivariable risk predictive algorithms (MVRPs) can be used for risk stratification and planning preventive actions among individuals at high risk of developing major depression, a new study found. Researchers recruited 350 high-risk men and 350 high-risk women aged ≥18 years who had not had a depressive episode in the past 2 months, were at high risk of major depressive episode (MDE) based on the MVRPs, and agreed to be contacted for follow-up interview. The MVRPs were developed and validated using longitudinal data from >1,000 Canadians. Eligible participants were randomized into the control group and the group receiving personalized depression risk information. Among the findings:

  • MVRPs can be used for risk stratification and planning preventive actions in this population.
  • The personalized risk information produced by MVRPs may empower users to actively engage in self-management.


Wang JL, et al. A randomized controlled trial to examine the impacts of disclosing personalized depression risk information on the outcomes of individuals who are at high risk of development major depression: a research protocol. [Published online ahead of print September 18, 2019]. BMC Psychiatry. doi: 10.1186/s12888-019-2270-9.


In psychiatry, we often try to predict risk of potential suicide in active clinical settings. We also study and memorize risk factors for certain psychiatric disorders for academic and diagnostic purposes. Wang et al. proposes a trial design to assess if advising patients that they are high risk for developing major depressive disorder will have a preventative effect? Some patients may view this as a stressor and fall into a depressive state more quickly. Others may pre-emptively try to address and lower their risk factors that are malleable and environmental. There are no findings yet, but the design of this study could be utilized for ADHD, bipolar disorder, and more. We may find that psychiatric disorder risk counseling shares a similar process as that of genetic risk counseling. Kudos for an interesting concept and design for future studies. —Thomas L. Schwartz, MD; Senior Associate Dean of Education, Interim Chair/Professor of Psychiatry, SUNY Upstate Medical University.