Evidence map›Paper›PMID 30763119›Full record

SynthesisCanadian journal of psychiatry. Revue canadienne de psychiatrie2019

Current and Common Definitions of Treatment-Resistant Depression: Findings from a Systematic Review and Qualitative Interviews.

Sage Brown, Katherine Rittenbach, Sarah Cheung, Gail McKean, Frank P MacMaster, Fiona Clement

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05866575 (Prediction of the Therapeutic Response in Depression Based on an Early Neuro-computational Modeling Assessment of Motivation), which is not on this map. Cited by 66 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
66citing papers in PubMed, 5 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.

NCT05866575 narecruitingnot on this mapstarted 2023, after this paper: background citation

Prediction of the Therapeutic Response in Depression Based on an Early Neuro-computational Modeling Assessment of Motivation

TypeinterventionalSponsorCentre Hospitalier St AnneRan2023 to 2026Enrolled136ConditionsMajor Depressive DisorderArmsescitalopram, vortioxetine
3 · Its place in the literature

Who cites it

66 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
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  5. Changes in RNA expression levels during antidepressant treatment: a systematic review.Journal of neural transmission (Vienna, Austria : 1996) · 2021
    Pooled it
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  11. Review
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  15. Negative allosteric modulation of α5-GABAbioRxiv : the preprint server for biology · 2026
    Article
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  18. Review
  19. Article
  20. Article

6 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

6 authors.

Sage Brown1 University of Calgary, Calgary, Alberta.
Katherine Rittenbach2 Addictions and Mental Health Strategic Clinical Network, University of Alberta, Edmonton, Alberta.
Sarah Cheung1 University of Calgary, Calgary, Alberta.
Gail McKean1 University of Calgary, Calgary, Alberta.
Frank P MacMaster2 Addictions and Mental Health Strategic Clinical Network, University of Alberta, Edmonton, Alberta.
Fiona Clement1 University of Calgary, Calgary, Alberta.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveNo universal definition for treatment-resistant depression (TRD) exists. This lack of consensus reduces the generalizability of study findings and limits the ability to study TRD. In addition, anecdotally, there may be a difference between the definitions of TRD within research and those applied in practice. Thus, the objective of this work was to identify current common definitions of TRD used in both research and clinical practice.

methodA systematic review of published literature was conducted to document TRD definitions. Extracted data were grouped based on patient cohort and method of defining TRD. Validation studies were narratively summarized. Interviews with 6 key informants were conducted to understand how definitions are applied in practice.

resultsIn total, 155 definitions for TRD were identified in the published literature, and 48.4% of all definitions specified requirement of at least 2 treatment failures. Key informant interviews indicated the concept of TRD is rarely employed in clinical practice. Instead, concepts like "complex needs," "struggling with their disease," and "chronic" are used. When asked directly about how they would define TRD, interview participants said an adequate trial of psychotherapy as well as an adequate trial of at least 2 to 3 antidepressant medications.

conclusionsThere is no universally accepted definition of TRD, and substantial heterogeneity exists. This study indicates discordance between the use of the term in research and clinical practice, with several key informants emphasizing that the terminology is rarely used in their clinical experience. Development of a shared, common definition across practice and research is required.

Indexed as

Terminology as TopicDepressive Disorder, Treatment-ResistantHumansPsychiatryand qualitative interviewmental healthstaging modelssystematic reviewtreatment resistant depression

Identifiers

PMID30763119
PMCPMC6591751

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.