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Phenotype Submission - Depressive Disorder with Anhedonia

Cohort Definition Name : Earliest Event of Depressive Disorder with Anhedonia
Contributor name : Joel Swerdel’, ‘Pranav Bhimani’
Contributor OrcId :
Logic Description : Earliest occurrence of either 1) a depressive disorder diagnosis that is preceded by an Anhedonia diagnosis in the prior year or 2) an anhedonia diagnosis that is preceded by a depressive disorder diagnosis in the prior year cohort exit is the end of continuous observation.
Recommended study application : target
Assertion statement : This cohort definition was executed on at least one real person-level observational health data source and resulted in a cohort with at least 1 person.
Target Clinical Description : Major depressive disorder with anhedonia (MDD ANH+) can be defined as clinical depression paired with the complete absence of pleasures/enjoyment. Anhedonia itself is defined as an impaired capacity to experience or anticipate pleasure and is considered a cardinal symptom of Major Depressive Disorder (MDD)[1]. The presence of anhedonia may either preface the diagnosis of MDD, lead to new onset of MDD, and/or signify the presence of other mental health issues/diseases. Furthermore, anhedonia has been linked to increased severity of depressive symptoms and reoccurrence/persistence of MDD[1]
Evaluation conclusion : MDD with anhedonia using a concept set of 1 concept which incorporated all those found from the literature review and from the analysis of PHOEBE and orphan concepts in cohort diagnostics. We performed the evaluation across a network of claim data sources and 1 EHR US data source. The data sources are: IBM® MarketScan® Commercial Database (CCAE), Optum’s longitudinal EHR repository (Optum EHR), Optum’s Clinformatics® Data Mart (DOD), IBM® MarketScan® Multi-State Medicaid Database (MDCD), IBM® MarketScan® Medicare Supplemental Database (MDCR), Japan Claims Database (JMDC), Clinical Practice Research Datalink (CPRD) , IQVIA® Australia Longitudinal Patient Data (LPD) database (Australia), IQVIA® Disease Analyzer (DA) France database (France), QVIA® Disease Analyzer (DA) Germany database (Germany), IQVIA® Adjudicated Health Plan Claims Data (formerly PharMetrics Plus) - US database (PharMetrics), IQVIA® Ambulatory EMR (EMR). The SNOMED concept is based on an ICD-10 code only. All data on anhedonia in US data bases will be from October 2015 onward. The algorithm retrieves subjects from 5 of the 8 databases tested. We developed a narrow cohort definition requiring a second diagnosis code for anhedonia in the time period 31-365 days after index. This cohort may improve the specificity of the algorithm albeit at the expense of sensitivity based on a comparison of cohort counts between the narrow and the broader (single code) definitions. The significant loss in sensitivity, however, precludes its use in the analysis.
The anhedonia cohort should be used with caution as it likely provides a large underestimate of the number of subjects with anhedonia in the database. Based on the clinical description and prior published literature, it has been estimated that 75% of subjects with MDD will experience co-morbid anhedonia. Based on subject counts, in our databases post-2016, 0.1-0.3% of subjects with MDD will experience anhedonia indicating a large underestimate. PheValuator results for the one database where we were able to generate results, MDCD, showed poor performance characteristics relative to the other subtypes, with a sensitivity around 0.5 and PPV around 0.35

Imported to the OHDSI Phenotype Library. It may be expected to be found with id = 1024 in the next release. Thank you