Life-course patterning of MLTC clusters and their patient-centred burden in depression: a population-based study...

Area of Science:

• Public Health Research
• Epidemiology
• Mental Health Studies

Background:

• Understanding the development and clustering of multiple long-term conditions (MLTC) across the life-course is a key public health priority.
• Limited evidence exists on how these patterns relate to patient-centered outcomes in individuals with mental health disorders, particularly depression.

Purpose of the Study:

• To evaluate patient-centered outcomes in patients with a history of depression and MLTC.
• To investigate the temporal patterns and clustering of MLTC in relation to patient-centered burden across the life-course.

Main Methods:

• Retrospective matched cohort study using UK primary care data (Clinical Practice Research Datalink).
• Patients with incident depression (≥10 years) were matched 1:1 to comparators without depression history.
• MLTC clusters were derived by life decade using multiple correspondence analysis and k-means clustering; patient-centered burden was assessed across eight themes.

Main Results:

• 78% of patients with depression (n=1,962,757) had MLTC versus 50% of comparators.
• MLTC clusters varied by decade: atopic/liver (early life), metabolic/cardiovascular (midlife), musculoskeletal/respiratory (later life).
• Patient-centered burden was higher in those with depression, with the strongest prognostic cluster for burden shifting across life stages.

Conclusions:

• Multiple long-term conditions (MLTC) are prevalent in patients with depression, exhibiting dynamic temporal patterns.
• MLTC leads to significant patient-centered burden from adolescence onwards.
• Identified decade-specific MLTC clusters can inform targeted prevention strategies for patients with depression.