Review finds lack of risk calculators to predict long-term depression and anxiety

There are very few risk calculators to predict how symptoms of anxiety and depression will change over the course of a person’s life, according to a recent review of past research. This is the first systematic review of risk calculators for forecasting depression and anxiety over the course of life.

The review, led by BRC researchers, is published in the Journal of Affective Disorders.

Depression and anxiety are common. In recent decades, the number of young people with anxiety and depression has risen sharply in developed countries. Roughly half of depression cases first emerge before age 30 and nearly 4 in 10 anxiety cases emerge before age 14.

If we can predict how a person’s levels of anxiety and depression will change over the course of their life, we can offer help early on to people with the most need. This could prevent symptoms getting worse and lessen the impact on their lives.

The researchers searched the databases MEDLINE, Embase and APA PsycINFO for relevant studies involving children and adults aged 3-65 years.

They found 9 studies of risk calculators to predict how depression and anxiety change over the course of life. Of these studies:

• 7 focused on adults
• 2 focused on children and adolescents

Only 1 study looked at anxiety levels – the others looked at depression.

Risk calculators used a wide range of factors to try and predict long-term depression and anxiety accurately. These included social and demographic factors like sex and family income. Some risk calculators included biological factors, like indicators of inflammation in the blood and body mass index.

The most common factor used in the risk calculators to predict a person’s long-term levels of depression and anxiety was their past mental health, and that of their family.

The reviewers noted that the risk calculators using a large number of different factors, or specialised factors like brain scans, didn’t always provide more accurate predictions.

This review shows that effective models for predicting the risk of persistent or worsening depression and anxiety are needed. This is particularly important for children and adolescents, who could be offered help while they are young, to prevent their symptoms continuing or worsening.

Sophie Fairweather, who led the review, said:

“This review highlights an important gap in mental health research.

“Rates of anxiety and depression in young people have risen sharply in recent years. We know these conditions most often manifest in childhood, yet we still lack ways to identify which children are most at risk.

“With better data and more advanced tools now available, we have a real opportunity to develop new ways to identify children who need help earlier, reduce the impact on their lives, and better target mental health service resources to those in most need.”