SynthesisDepression and anxiety2019
Aligning the many definitions of treatment resistance in anxiety disorders: A systematic review.
Synthesis in Depression and anxiety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Ketamine treatment for refractory anxiety: A systematic review.British journal of clinical pharmacology · 2022Pooled it
- Aligning the many definitions of treatment resistance in anxiety disorders: A systematic review.Depression and anxiety · 2019Pooled it
- Ketamine for treatment-resistant obsessive-compulsive disorder: Double-blind active-controlled crossover study.Journal of psychopharmacology (Oxford, England) · 2025Trial
- Ketamine effects on EEG and their links to therapy differ across treatment-resistant major depression, post-traumatic stress disorder, and obsessive-compulsive disorder.The international journal of neuropsychopharmacology · 2026Article
- Mechanistic Non-Response After Psychotherapy for Anxiety Disorders: A Maintenance-Mechanism-Based Clinical Taxonomy.Journal of clinical medicine · 2026Review
- Hope for Neurotic Disorders: A Summary of New Zealand Research on the Development of Biomarkers and Novel Treatments.Journal of the Royal Society of New Zealand · 2026Article
- Neural mechanisms underlying cognitive inflexibility in obsessive-compulsive disorder: a review.Frontiers in psychiatry · 2026Review
- Associations of cMIND Diet with depressive and anxiety symptoms among old people in China: a nationwide study.European journal of nutrition · 2025Article
- Transcranial Focused Ultrasound Neuromodulation in Psychiatry: Main Characteristics, Current Evidence, and Future Directions.Brain sciences · 2024Review
- Is lack of goal-conflict-specific rhythmicity a biomarker for treatment resistance in generalised anxiety but not social anxiety or major depression?Journal of psychopharmacology (Oxford, England) · 2024Article
- [Treatment resistance in anxiety disorders-Definition and treatment options].Der Nervenarzt · 2024Review
- [Non-response to psychotherapy: concepts, problems and referral options].Der Nervenarzt · 2024Review
- The definition of treatment resistance in anxiety disorders: a Delphi method-based consensus guideline.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2024Article
- Preliminary Evaluation of Translated and Culturally Adapted Internet-Delivered Cognitive Therapy for Social Anxiety Disorder: Multicenter, Single-Arm Trial in Japan.JMIR formative research · 2023Article
- Individual cognitive therapy reduces frontal-thalamic resting-state functional connectivity in social anxiety disorder.Frontiers in psychiatry · 2023Article
- Right Frontal Theta: Is It a Response Biomarker for Ketamine's Therapeutic Action in Anxiety Disorders?Frontiers in neuroscience · 2022Article
- Neuropsychological Theory as a Basis for Clinical Translation of Animal Models of Neuropsychiatric Disorder.Frontiers in behavioral neuroscience · 2022Article
- Precision clinical trials: a framework for getting to precision medicine for neurobehavioural disorders.Journal of psychiatry & neuroscience : JPN · 2021Review
- Systematic review and meta-analysis of randomized controlled trials of ketamine in the treatment of refractory anxiety spectrum disorders.Therapeutic advances in psychopharmacology · 2021Article
- Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Anxiety Disorders often show a chronic course, even when treated with one of the various effective treatments available. Lack of treatment effect could be due to Treatment Resistance (TR). Consensus on a definition for TR Anxiety Disorders (TR-AD) is highly needed as currently many different operationalizations are in use. Therefore, generalizability in current TR-AD research is suboptimal, hampering improvement of clinical care. The objective of this review is to evaluate the currently used definitions of TR-AD by performing a systematic review of available literature. Out of a total of n = 13 042, 62 studies that operationalized TR-AD were included. The current review confirms a lack of consensus on TR-AD criteria. In 62.9% of the definitions, TR was deemed present after the first treatment failure. Most studies (93.0%) required pharmacological treatment failures, whereas few (29.0%) required psychological treatment failures. However, criteria for what constitutes "treatment failure" were not provided in the majority of studies (58.1%). Definitions for minimal treatment duration ranged from at least 4 weeks to at least 6 months. Almost half of the TR-AD definitions (46.8%) required elevated anxiety severity levels in TR-AD. After synthesis of the results, the consensus definition considers TR-AD present after both at least one first-line pharmacological and one psychological treatment failure, provided for an adequate duration (at least 8 weeks) with anxiety severity remaining above a specified threshold. This definition could contribute to improving course prediction and identifying more targeted treatment options for the highly burdened subgroup of TR-AD patients.
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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.