Evidence map›Paper›PMID 26152228›Full record

SynthesisThe international journal of neuropsychopharmacology2015

Prevention of Relapse and Recurrence in Adults with Major Depressive Disorder: Systematic Review and Meta-Analyses of Controlled Trials.

Kang Sim, Wai Keat Lau, Jordan Sim, Min Yi Sum, Ross J Baldessarini

Erratum issuedOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The international journal of neuropsychopharmacology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 87 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
87citing papers in PubMed, 8 pooled it
9.3field-weighted citation impact, top 2% of its field
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

87 citing papers in PubMed, 8 syntheses or guidelines pooled it, 216 citations in OpenAlex.

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27 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Kang SimYong Loo Lin School of Medicine, National University of Singapore (Drs K Sim, Lau, and J Sim); Research Department, Institute of Mental Health, Singapore (Dr K Sim and Ms Sum); Department of General Psychiatry, Institute of Mental Health, Singapore (Dr K Sim); Department of Psychiatry, Harvard Medical School, Boston, MA (Dr Baldessarini); International Consortium for Psychotic and Mood Disorders Research, McLean Hospital, Belmont, MA (Dr Baldessarini). kang_sim@imh.com.sg.
Wai Keat LauYong Loo Lin School of Medicine, National University of Singapore (Drs K Sim, Lau, and J Sim); Research Department, Institute of Mental Health, Singapore (Dr K Sim and Ms Sum); Department of General Psychiatry, Institute of Mental Health, Singapore (Dr K Sim); Department of Psychiatry, Harvard Medical School, Boston, MA (Dr Baldessarini); International Consortium for Psychotic and Mood Disorders Research, McLean Hospital, Belmont, MA (Dr Baldessarini).
Jordan SimYong Loo Lin School of Medicine, National University of Singapore (Drs K Sim, Lau, and J Sim); Research Department, Institute of Mental Health, Singapore (Dr K Sim and Ms Sum); Department of General Psychiatry, Institute of Mental Health, Singapore (Dr K Sim); Department of Psychiatry, Harvard Medical School, Boston, MA (Dr Baldessarini); International Consortium for Psychotic and Mood Disorders Research, McLean Hospital, Belmont, MA (Dr Baldessarini).
Min Yi SumYong Loo Lin School of Medicine, National University of Singapore (Drs K Sim, Lau, and J Sim); Research Department, Institute of Mental Health, Singapore (Dr K Sim and Ms Sum); Department of General Psychiatry, Institute of Mental Health, Singapore (Dr K Sim); Department of Psychiatry, Harvard Medical School, Boston, MA (Dr Baldessarini); International Consortium for Psychotic and Mood Disorders Research, McLean Hospital, Belmont, MA (Dr Baldessarini).
Ross J BaldessariniYong Loo Lin School of Medicine, National University of Singapore (Drs K Sim, Lau, and J Sim); Research Department, Institute of Mental Health, Singapore (Dr K Sim and Ms Sum); Department of General Psychiatry, Institute of Mental Health, Singapore (Dr K Sim); Department of Psychiatry, Harvard Medical School, Boston, MA (Dr Baldessarini); International Consortium for Psychotic and Mood Disorders Research, McLean Hospital, Belmont, MA (Dr Baldessarini).
Institute of Mental Health · SGHarvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFindings of substantial remaining morbidity in treated major depressive disorder (MDD) led us to review controlled trials of treatments aimed at preventing early relapses or later recurrences in adults diagnosed with MDD to summarize available data and to guide further research.

methodsReports (n = 97) were identified through systematic, computerized literature searching up to February 2015. Treatment versus control outcomes were summarized by random-effects meta-analyses.

resultsIn 45 reports of 72 trials (n = 14 450 subjects) lasting 33.4 weeks, antidepressants were more effective than placebos in preventing relapses (response rates [RR] = 1.90, confidence interval [CI]: 1.73-2.08; NNT = 4.4; p < 0.0001). In 35 reports of 37 trials (n = 7253) lasting 27.0 months, antidepressants were effective in preventing recurrences (RR = 2.03, CI 1.80-2.28; NNT = 3.8; p < 0.0001), with minor differences among drug types. In 17 reports of 22 trials (n = 1 969) lasting 23.7 months, psychosocial interventions yielded inconsistent or inconclusive results.

conclusionsDespite evidence of the efficacy of drug treatment compared to placebos or other controls, the findings further underscore the substantial, unresolved morbidity in treated MDD patients and strongly encourage further evaluations of specific, improved individual and combination therapies (pharmacological and psychological) conducted over longer times, as well as identifying clinical predictors of positive or unfavorable responses and of intolerability of long-term treatments in MDD.

Indexed as

Antidepressive AgentsCombined Modality TherapyControlled Clinical Trials as TopicHumansMajor Depressive DisorderPsychotherapyRecurrenceSecondary PreventionAntidepressive AgentsAntidepressantsdepressionmajor depressionpsychotherapyrecurrencerelapse

Identifiers

PMID26152228
PMCPMC4772815
OpenAlexW1913659607

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.