MANTO: Predicting Depression

A group of researchers from the University of Ferrara, Bologna, New York, and Stockholm have developed a tool to predict the risk of developing depression in people over 55. Anyone can calculate their risk through a website. Here Martino Belvederi Murri (Ferrara) reports on the study that could mark a turning point in terms of early identification and prevention of this condition.

The prophetess Manto

According to the World Health Organization, depression is the leading cause of disability in the world. About 15% of people suffer from depression at least once in their life: the consequences can range from temporary suffering to the loss of work and social relationships, to suicide. The impact of the pandemic, isolation, the economic crisis and the population aging make depression a widespread economic and social problem, especially in late life. Unfortunately, depression often goes unrecognized or does not receive prompt treatment. This is due to several factors, such as scarcity of information, stigma, or insufficient public mental healthcare resources.

The early identification and prevention of depression is an innovative, desirable approach. Everyone can develop depression under difficult circumstances, but some people have higher risk than others. Risk factors for depression include being female, experiencing sleep disturbances, pain, or other physical symptoms, and a previous history of depression.

The Manto Depression Risk Calculator is the first tool available worldwide to provide a personalized estimate of the risk of developing depression over the next two years. It takes its name from Manto who, according to legend, was the prophetess who created the lake of the city of Mantua with her tears. To use Manto, it is sufficient to go to the site and answer some questions about symptoms of depression and some other aspects of life. 

Anonymity is guaranteed and it is not mandatory to fill in all of them, but the more answers are provided, the more accurate the estimate will be. At the end of the short questionnaire (currently in the Italian and English language) the site will produce an estimate of the individual risk score, expressed as a percentage. The calculator is intended for use by adults aged 55 or over without severe cognitive problems. 

Manto calculates the risk score processing data that derive from information on risk factors. Researchers used estimates from the scientific literature and European population data to obtain a statistical model with good discriminatory capacity. The study has just been published in the American Journal of Geriatric Psychiatry and is the product of the collaboration between Martino Belvederi Murri, from the University of Ferrara,  Luca Cattelani, Federico Chesani and Pierpaolo Palumbo, from the University of Bologna, Federico Triolo, from the Karolinska Institutet of Stockholm, and George Alexopoulos from Cornell University in New York. 

Martino Belvederi Murri presents MANTO

The project could have important positive effects for people who will use the site and could be used to develop healthcare strategies. Depression in old age has in fact significant personal and health costs. Manto can be used to identify populations at risk to target public health interventions. The researchers responsible for Manto said:

"It is a great satisfaction to make our work available. Manto is the first model of its type that can be used freely. For years, anyone could use online tools to predict the risk of developing heart disease, but no similar instrument was available for mental health, which is too important. We hope that Manto serves people and professionals in the sector, such as General Practitioners or mental health specialists. We would also like to draw attention to the issue of depression, which must be recognized without shame and can be treated at all ages. However, we will not stop here: we aim to develop newer versions of Manto, further improving personalization and precision"

One key question is what a person should do if the Manto Depression Risk Calculator says they are at high risk of depression. If Manto's "prophecy" says that the person's risk score is high (for instance, higher than 60%), there is no need to panic. Several risk factors for depression can be modified. For example, one can treat sleep disturbance or pain, exercise, engage in pleasurable or intellectually stimulating activities. Other preventive treatments and actions are also available, such as psychological, pharmacological and behavioral strategies, alone or in combination. If a person believes that are already depressed, then they need to consult their healthcare provider.