Evidence map›Paper›PMID 29492960›Full record

Observational studyActa psychiatrica Scandinavica2018

Clinical correlates of augmentation/combination treatment strategies in major depressive disorder.

M Dold, L Bartova, J Mendlewicz, D Souery, A Serretti, S Porcelli, J Zohar, S Montgomery, S Kasper

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in Acta psychiatrica Scandinavica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
4.9field-weighted citation impact, top 5% 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

19 citing papers in PubMed, 47 citations in OpenAlex.

  1. Article
  2. Article
  3. Korean Medication Algorithm for Depressive Disorder 2025, Fifth Revision: An Executive Summary.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2025
    Article
  4. Review
  5. Age as a moderating factor of treatment resistance in depression.European psychiatry : the journal of the Association of European Psychiatrists · 2023
    Article
  6. Article
  7. Article
  8. Article
  9. Polygenic risk scores for neuropsychiatric, inflammatory, and cardio-metabolic traits highlight possible genetic overlap with suicide attempt and treatment-emergent suicidal ideation.American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics · 2022
    Article
  10. Review
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  13. Article
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  16. Article
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  19. Observational
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

9 authors at 5 institutions in 5 countries.

M DoldDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.ORCID 0000-0001-8914-2192
L BartovaDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
J MendlewiczSchool of Medicine, Free University of Brussels, Brussels, Belgium.
D SouerySchool of Medicine, Free University of Brussels, Brussels, Belgium.
A SerrettiDepartment of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
S PorcelliDepartment of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
J ZoharPsychiatric Division, Chaim Sheba Medical Center, Tel Hashomer, Israel.
S MontgomeryImperial College, University of London, London, United Kingdom.
S KasperDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
Medical University of Vienna · ATUniversity of Bologna · ITEuropean Research Council · BESheba Medical Center · ILUniversity of London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis multicenter, multinational, cross-sectional study aimed to investigate clinical characteristics and treatment outcomes associated with augmentation/combination treatment strategies in major depressive disorder (MDD).

methodSociodemographic, clinical, and treatment features of 1410 adult MDD patients were compared between MDD patients treated with monotherapy and augmentation/combination medication using descriptive statistics, analyses of covariance (ancova), and Spearman's correlation analyses.

results60.64% of all participants received augmentation and/or combination strategies with a mean number of 2.18 ± 1.22 simultaneously prescribed psychiatric drugs. We found male gender, older age, Caucasian descent, higher weight, low educational status, absence of occupation, psychotic symptoms, melancholic and atypical features, suicide risk, in-patient treatment, longer duration of hospitalization, some psychiatric comorbidities (panic disorder, agoraphobia, obsessive-compulsive disorder, and bulimia nervosa), comorbid somatic comorbidity in general and concurrent hypertension, thyroid dysfunction, diabetes, and heart disease in particular, higher current and retrospective Montgomery and Åsberg Depression Rating Scale total scores, treatment resistance, and higher antidepressant dosing to be significantly associated with augmentation/combination treatment. These findings were corroborated when examining the number of concurrently administered psychiatric drugs in the statistical analyses.

conclusionOur findings suggest a clear association between augmentation/combination strategies and treatment-resistant/difficult-to-treat MDD conditions characterized by severe symptomatology and high amount of psychiatric and somatic comorbidities.

Indexed as

ComorbidityAdultAntidepressive AgentsAntipsychotic AgentsBenzodiazepinesCross-Sectional StudiesDepressive Disorder, Treatment-ResistantDrug SynergismDrug Therapy, CombinationEuropeFemaleHumansMajor Depressive DisorderMaleMiddle AgedRetrospective StudiesAntidepressive AgentsAntipsychotic AgentsBenzodiazepinesTranquilizing Agentsaugmentationcombinationcomorbiditiesmajor depressive disordertreatment response

Identifiers

PMID29492960
PMCPMC5947736
OpenAlexW2790990061

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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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.