Trial reportThe American journal of psychiatry2009
Predictors of spontaneous and systematically assessed suicidal adverse events in the treatment of SSRI-resistant depression in adolescents (TORDIA) study.
Trial report in The American journal of psychiatry, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 81 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Treatment of SSRI-Resistant Depression in Adolescents (TORDIA)
A Preliminary Study of the Efficacy and Safety of Carbamazepine in Severe Liver Disease Due to Alpha-1 Antitrypsin Deficiency
Who cites it
81 citing papers in PubMed, 11 syntheses or guidelines pooled it, 239 citations in OpenAlex.
- Pooled it
- The current state-of-the-art in pharmacotherapy for pediatric generalized anxiety disorder.Expert opinion on pharmacotherapy · 2023Pooled it
- Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review.The American journal of psychiatry · 2021Pooled it
- Antidepressant Tolerability in Pediatric Anxiety and Obsessive-Compulsive Disorders: A Bayesian Hierarchical Modeling Meta-analysis.Journal of the American Academy of Child and Adolescent Psychiatry · 2020Pooled it
- The Impact of Antidepressant Dose and Class on Treatment Response in Pediatric Anxiety Disorders: A Meta-Analysis.Journal of the American Academy of Child and Adolescent Psychiatry · 2018Pooled it
- Eliciting adverse effects data from participants in clinical trials.The Cochrane database of systematic reviews · 2018Pooled it
- Comparative Effectiveness and Safety of Cognitive Behavioral Therapy and Pharmacotherapy for Childhood Anxiety Disorders: A Systematic Review and Meta-analysis.JAMA pediatrics · 2017Pooled it
- Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 6. Special Populations: Youth, Women, and the Elderly.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2016Pooled it
- Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents.The Cochrane database of systematic reviews · 2014Pooled it
- Treating nonsuicidal self-injury: a systematic review of psychological and pharmacological interventions.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2014Pooled it
- Guideline
- Trajectories of parent criticism across treatment for youth self-harm.Journal of child psychology and psychiatry, and allied disciplines · 2025Trial
- The heterogeneity of symptom reporting across study sites: a secondary analysis of a randomised placebo-controlled multicentre antimalarial trial.BMC medical research methodology · 2023Trial
- Treatment-Resistant Depression in Adolescents: Clinical Features and Measurement of Treatment Resistance.Journal of child and adolescent psychopharmacology · 2020Trial
- Parent-teen communication predicts treatment benefit for depressed and suicidal adolescents.Journal of consulting and clinical psychology · 2019Trial
- As Safe as Possible (ASAP): A Brief App-Supported Inpatient Intervention to Prevent Postdischarge Suicidal Behavior in Hospitalized, Suicidal Adolescents.The American journal of psychiatry · 2018Trial
- Impact of treatments for depression on comorbid anxiety, attentional, and behavioral symptoms in adolescents with selective serotonin reuptake inhibitor-resistant depression.Journal of the American Academy of Child and Adolescent Psychiatry · 2013Trial
- The bi-directional relationship between parent-child conflict and treatment outcome in treatment-resistant adolescent depression.Journal of the American Academy of Child and Adolescent Psychiatry · 2013Trial
- A randomized controlled trial of risperidone, lithium, or divalproex sodium for initial treatment of bipolar I disorder, manic or mixed phase, in children and adolescents.Archives of general psychiatry · 2012Trial
- Do sub-syndromal manic symptoms influence outcome in treatment resistant depression in adolescents? A latent class analysis from the TORDIA study.Journal of affective disorders · 2012Trial
21 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Commented on by
- Erratum issued
Authors and funding
21 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveThe authors sought to identify predictors of self-harm adverse events in treatment-resistant, depressed adolescents during the first 12 weeks of treatment.
methodDepressed adolescents (N=334) who had not responded to a previous trial with an SSRI antidepressant were randomized to a switch to either another SSRI or venlafaxine, with or without cognitive behavior therapy. Self-harm events, i.e., suicidal and non-suicidal self-injury adverse events were assessed by spontaneous report for the first 181 participants, and by systematic weekly assessment for the last 153 participants.
resultsHigher rates of suicidal (20.8% vs. 8.8%) and nonsuicidal self-injury (17.6% vs. 2.2%), but not serious adverse events (8.4% vs. 7.3%) were detected with systematic monitoring. Median time to a suicidal event was 3 weeks, predicted by high baseline suicidal ideation, family conflict, and drug and alcohol use. Median time to nonsuicidal self-injury was 2 weeks, predicted by previous history of nonsuicidal self-injury. While there were no main effects of treatment, venlafaxine treatment was associated with a higher rate of self-harm adverse events in those with higher suicidal ideation. Adjunctive use of benzodiazepines, while in a small number of participants (N=10) was associated with higher rate of both suicidal and nonsuicidal self-injury adverse events.
conclusionsSince predictors of suicidal adverse events also predict poor response to treatment, and many of these events occurred early in treatment, improving the speed of response to depression, by targeting of family conflict, suicidal ideation, and drug use may help to reduce their incidence. The relationship of venlafaxine and of benzodiazepines to self-harm events requires further study and clinical caution.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.