Evidence map›Paper›PMID 25007419›Full record

ArticleCanadian journal of psychiatry. Revue canadienne de psychiatrie2014

Treatment-resistant depression in primary care across Canada.

Sakina J Rizvi, Etienne Grima, Mary Tan, Susan Rotzinger, Peter Lin, Roger S Mcintyre, Sidney H Kennedy

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 4 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

78 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Respiratory disease in people with major depressive disorder: A systematic review and Meta-analysis.European psychiatry : the journal of the Association of European Psychiatrists · 2025
    Pooled it
  2. Magnetic seizure therapy for treatment-resistant depression.The Cochrane database of systematic reviews · 2021
    Pooled it
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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Sakina J RizviStudent, Departments of Pharmaceutical Sciences and Neuroscience, University of Toronto, Toronto, Ontario; Clinical Research Coordinator, Department of Psychiatry, University Health Network, Toronto, Ontario.
Etienne GrimaChief Operating Officer and Chief Financial Officer, Canadian Heart Research Centre, Toronto, Ontario.
Mary TanStatistician, Canadian Heart Research Centre, Toronto, Ontario.
Susan RotzingerProject Manager, Department of Psychiatry, University Health Network, Toronto, Ontario.
Peter LinDirector of Primary Care Initiatives, Canadian Heart Research Centre, Toronto, Ontario.
Roger S McintyrePsychiatrist, Department of Psychiatry, University Health Network, Toronto, Ontario; Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario; Professsor, Department of Pharmacology, University of Toronto, Toronto, Ontario.
Sidney H KennedyPsychiatrist, Department of Psychiatry, University Health Network, Toronto, Ontario; Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario; Professor, Institute of Medical Sciences, University of Toronto, toronto, Ontario.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTreatment-resistant depression (TRD) represents a considerable global health concern. The goal of the InSight study was to investigate the prevalence of TRD and to evaluate its clinical characterization and management, compared with nonresistant depression, in primary care centres.

methodsPhysicians completed a case report on a consecutive series of patients with major depressive disorder (n = 1212), which captured patient demographics and comorbidity, as well as current and past medication.

resultsUsing failure to respond to at least 2 antidepressants (ADs) from different classes as the definition of TRD, the overall prevalence was 21.7%. There were no differences in prevalence between men and women or among ethnicities. Patients with TRD had longer episode duration, were more likely to receive polypharmacy (for example, psychotropic, lipid-lowering, and antiinflammatory agents), and reported more AD related side effects. Higher rates of disability and comorbidity (axes I to III) were associated with treatment resistance. Obesity and being overweight were also associated with treatment resistance. While the selection and sequencing of pharmacotherapy by family physicians in this sample was in line with recommendations from evidence-based treatment guidelines, the wait time to make a change in treatment was 6 to 8 weeks in both groups, which exceeds guideline recommendations.

conclusionsThese real-world data demonstrate the high prevalence of TRD in primary care settings, and underscore the substantial burden of illness associated with TRD.

Indexed as

AdultAntidepressive AgentsCanadaComorbidityCross-Sectional StudiesDepressive Disorder, Treatment-ResistantDrug SubstitutionDrug Therapy, CombinationFemaleGuideline AdherenceHealth SurveysHumansMajor Depressive DisorderMaleMiddle AgedPrimary Health CareAntidepressive Agents

Identifiers

PMID25007419
PMCPMC4086317

What OpenQuestion holds

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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.