Predicting recurrence of major depressive episodes using the Depression Implicit Association Test: A Canadian biomarker integration network in depression (CAN-BIND) report.

Identifying clinically relevant predictors of depressive recurrence following treatment for Major Depressive Disorder (MDD) is critical for relapse prevention. Implicit self-depressed associations (SDAs), defined as implicit cognitive associations between elements of depression (e.g., sad, miserable) and oneself, often persist following depressive episodes and may represent a cognitive biomarker for future recurrences. Thus, we examined whether SDAs, and changes in SDAs over time, prospectively predict depressive recurrence among treatment responders in the CAN-BIND Wellness Monitoring for MDD Study, a prospective cohort study conducted across 5 clinical centres. A total of 96 patients with MDD responding to various treatments were followed an average of 1.01 years. Participants completed the Depression Implicit Association Test (DIAT) - a computer-based measure of SDAs - every 8 weeks on a tablet device. Survival analyses indicated that greater SDAs at baseline and increases in SDAs over time predicted shorter time to MDD recurrence, even after accounting for depressive symptom severity. The findings show that SDAs are a robust prognostic indicator of risk for MDD recurrence, and that the DIAT may be a feasible and low-cost clinical screening tool. SDAs also represent a potential mechanism underlying the course of recurrent depression and are a promising target for relapse prevention interventions.
Competing Interests: Declaration of Competing Interest KR, JM, IJT, TC, JF, BNF, KLH, KH, LCQ, and RU disclose no relevant conflict of interests. QSL is an employee of Janssen Research and Development, LLC. RM has received consulting and speaking honoraria from AbbVie, Eisai, Janssen, Lallemand, Lundbeck, Neonmind, and Otsuka, and research grants from CAN-BIND, CIHR, Janssen, Nubiyota, OBI and OMHF. SR has grant funding from Ontario Brain Institute and holds a patent “Teneurin C-Terminal Associated Peptides (TCAP) and methods and uses thereof.” CNS has received consulting honoraria from Eisai, Lundbeck, Otsuka, Diamond Therapeutics and Bayer and research grants from Ontario Brain Institute, SEAMO Innovation Funds and Clairvoyant. SHK has received research funding or honoraria from Abbvie, Abbott, Brain Canada, Boehringer-Ingelheim, Canadian Institutes of Health Research, Janssen, Lundbeck, Lundbeck Institute, Merck, Neurocrine, Ontario Brain Institute, Otsuka, Pfizer, SPOR (Canada's Strategy for Patient-Oriented Research), Sunovion and Servier; and holds stock/stock options in Field Trip Health. RWL has received honoraria for ad hoc speaking or advising/consulting, or received research funds, from Abbvie, Asia-Pacific Economic Cooperation, Bausch, BC Leading Edge Foundation, Brain Canada, Canadian Institutes of Health Research, Canadian Network for Mood and Anxiety Treatments, Healthy Minds Canada, CAN-BIND Solutions, Janssen, Lundbeck, Medscape, Michael Smith Foundation for Health Research, MITACS, Neurotorium, Ontario Brain Institute, Otsuka, Pfizer/Viatris, Unity Health, and VGH-UBCH Foundation.
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