Evidence map›Paper›PMID 23444423›Full record

SynthesisBMJ (Clinical research ed.)2013

Influence of initial severity of depression on effectiveness of low intensity interventions: meta-analysis of individual patient data.

Peter Bower, Evangelos Kontopantelis, Alex Sutton, Tony Kendrick, David A Richards, Simon Gilbody, Sarah Knowles, Pim Cuijpers, Gerhard Andersson, Helen Christensen and 9 more

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 150 papers, 21 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
150citing papers in PubMed, 21 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

150 citing papers in PubMed, 21 syntheses or guidelines pooled it.

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  15. Does aerobic exercise reduce postpartum depressive symptoms? a systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017
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90 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Peter BowerNIHR School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK. peter.bower@manchester.ac.uk
Evangelos Kontopantelis
Alex Sutton
Tony Kendrick
David A Richards
Simon Gilbody
Sarah Knowles
Pim Cuijpers
Gerhard Andersson
Helen Christensen
Björn Meyer
Marcus Huibers
Filip Smit
Annemieke van Straten
Lisanne Warmerdam
Michael Barkham
Linda Bilich
Karina Lovell
Emily Tung-Hsueh Liu

Funding

Department of Health 06/43/05Department of Health HTA/06/43/504Medical Research Council G0701013Medical Research Council MC_PC_13042Medical Research Council MR/K006665/1
6 · The paper itself

Abstract

objectiveTo assess how initial severity of depression affects the benefit derived from low intensity interventions for depression.

designMeta-analysis of individual patient data from 16 datasets comparing low intensity interventions with usual care.

settingPrimary care and community settings.

participants2470 patients with depression.

interventionsLow intensity interventions for depression (such as guided self help by means of written materials and limited professional support, and internet delivered interventions).

main outcome measuresDepression outcomes (measured with the Beck Depression Inventory or Center for Epidemiologic Studies Depression Scale), and the effect of initial depression severity on the effects of low intensity interventions.

resultsAlthough patients were referred for low intensity interventions, many had moderate to severe depression at baseline. We found a significant interaction between baseline severity and treatment effect (coefficient -0.1 (95% CI -0.19 to -0.002)), suggesting that patients who are more severely depressed at baseline demonstrate larger treatment effects than those who are less severely depressed. However, the magnitude of the interaction (equivalent to an additional drop of around one point on the Beck Depression Inventory for a one standard deviation increase in initial severity) was small and may not be clinically significant.

conclusionsThe data suggest that patients with more severe depression at baseline show at least as much clinical benefit from low intensity interventions as less severely depressed patients and could usefully be offered these interventions as part of a stepped care model.

Indexed as

AdultDepressive DisorderFemaleHumansMaleMiddle AgedPsychiatric Status Rating ScalesPsychotherapySeverity of Illness IndexUnited Kingdom

Identifiers

PMID23444423
PMCPMC3582703

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.