Evidence map›Paper›PMID 27314661›Full record

SynthesisThe Journal of clinical psychiatry2017

A Meta-Analysis of D-Cycloserine in Exposure-Based Treatment: Moderators of Treatment Efficacy, Response, and Diagnostic Remission.

Joseph F McGuire, Monica S Wu, John Piacentini, James T McCracken, Eric A Storch

Open access · greenAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Journal of clinical psychiatry, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
4.2field-weighted citation impact, top 6% 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

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.

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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

5 authors at 2 institutions in 1 country.

Joseph F McGuireSemel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, 48-228B, Los Angeles, CA, 90095. jfmcguire@mednet.ucla.edu.
Monica S WuDepartment of Psychology, University of South Florida, Tampa, Florida, USA.
John PiacentiniSemel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, California, USA.
James T McCrackenSemel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, California, USA.
Eric A StorchDepartments of Psychology, University of South Florida, Tampa, Florida, USA.
University of California, Los Angeles · USUniversity of South Florida · US

Funding

TRAINING THE SCIENCE OF CHILD MENTAL HEALTH TREATMENTT32MH073517 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SUMA JACOB, John C. Piacentini · 2006 to 2026
$5.2M
NIMH NIH HHS T32 MH073517
6 · The paper itself

Abstract

objectiveThis meta-analysis examined treatment efficacy, treatment response, and diagnostic remission effect sizes and moderators of D-cycloserine-augmented exposure treatment in randomized controlled trials (RCTs) of individuals with anxiety disorders, obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). DATA SOURCES AND STUDY SELECTION: The terms D-cycloserine AND randomized controlled trial were used to search the PubMed (1965-May 2015), PsycINFO, and Scopus databases for randomized placebo-controlled trials of D-cycloserine-augmented exposure therapy for anxiety disorders, OCD, and PTSD. DATA EXTRACTION: Clinical variables and effect sizes were extracted from 20 RCTs (957 participants). A random-effects model calculated the effect sizes for treatment efficacy, treatment response, and diagnostic remission using standardized rating scales. Subgroup analyses and meta-regression were used to examine potential moderators.

resultsA small, nonsignificant benefit of D-cycloserine augmentation compared to placebo augmentation was identified across treatment efficacy (g = 0.15), response (risk ratio [RR] = 1.08), and remission (RR = 1.109), with a moderately significant effect (P = .03) for anxiety disorders specifically (g = 0.33). At initial follow-up assessments, a small, nonsignificant effect size of D-cycloserine augmentation compared to placebo was found for treatment efficacy (g = 0.21), response (RR = 1.06), and remission (RR = 1.12). Specific treatment moderators (eg, comorbidity, medication status, gender, publication year) were found across conditions for both acute treatment and initial follow-up assessments.

conclusionsD-Cycloserine does not universally enhance treatment outcomes but demonstrates promise for anxiety disorders. Distinct treatment moderators may account for discrepant findings across RCTs and disorders. Future trials may be strengthened by accounting for identified moderators in their design, with ongoing research needed on the mechanisms of D-cycloserine to tailor treatment protocols and maximize its benefit.

Indexed as

Implosive TherapyAdolescentAdultAgedAnxiety DisordersChildCombined Modality TherapyCycloserineFemaleHumansMaleMiddle AgedObsessive-Compulsive DisorderPsychiatric Status Rating ScalesPsychometricsRandomized Controlled Trials as TopicCycloserine

Identifiers

PMID27314661
PMCPMC5967394
OpenAlexW2440481462

What OpenQuestion holds

Textmetadata
LicenceTDM
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.