Predicting response to CBT for depression in primary care: how close are we to stratified care? Seminar

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Stratified medicine aims to improve clinical and cost-effectiveness by identifying moderators of treatment that indicate differential response to treatment, and treating patients accordingly. While the rationale for such an approach is sound, the evidence to support effective stratification for common mental health problems is lacking. I will present data from analyses using data from two large randomised controlled trials of Cognitive Behavioural Therapy (CBT) for depression in primary care. We used linear regression to test for interactions between treatment effect and putative moderator variables using data from the IPCRESS and CoBalT randomised controlled trials. Despite a couple of potential moderators, the findings were largely null. I will discuss the limitations of these findings and our approach more generally, and discuss whether recent developments in analysis from other groups in the field are more promising.