Attitudes towards a multimodal precision medicine algorithm for predicting treatment response in depression: findings from a large cross-sectional European survey.

Background: Precision medicine aims to facilitate a more individualized treatment selection and a more accurate diagnosis. While there is broad ranging research on precision psychiatry and the corresponding computational tools, its concepts and implementation are underway, little is known about the attitudes towards the actual use of precision psychiatry tools in the management of major psychiatric disorders, such as Major Depressive Disorder (MDD). This study aims to investigate the attitudes of depressive patients, professionals (physicians, psychologists and scientists) and the general population towards a novel, multimodal precision medicine algorithm designed to predict antidepressant treatment response. Methods: 5490 participants from 21 European countries, consisting of three groups of stakeholders, patients with depression (n= 421), professionals (n = 367) and the general population (n = 4702), were polled with a newly developed cross-sectional survey. A hypothetical decision scenario was used to examine the participants' attitudes, in which they were asked for their approval or disapproval for the application of a multimodal precision medicine algorithm to predict treatment response in antidepressant-treatment.3. Results: The general population had an acceptance rate of 78.8%. Overall, 74.6% of patients with MDD would agree to undergo testing using the multimodal algorithm in their current situation and 80.2% reported they would have done so at the time of their first diagnosis. In contrast, the psychiatrist's acceptance rates towards a multimodal algorithm were higher when patients had been in treatment for some time (79.3%) compared to those who had only recently been diagnosed (55.2%). This pattern was present across all other specialties within the professionals group. A considerable number of participants wished to receive more information before deciding, but few declined its application altogether. All groups indicated an openness towards personalized treatment options in general. Conclusion: Overall, participants indicated a large degree of acceptance towards the application of a multimodal precision medicine algorithm. Although limited by the hypothetical nature of the decision scenario, this study provides valuable perspectives from different stakeholders. Future research should move beyond attitudes and address further implementation hurdles that need to be overcome for the successful implementation of novel precision psychiatry approaches in psychiatric care.