SynthesisBMC medicine2020
Psychotherapy or medication for depression? Using individual symptom meta-analyses to derive a Symptom-Oriented Therapy (SOrT) metric for a personalised psychiatry.
Synthesis in BMC medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 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.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Effectiveness of interventions for anxiety and depression in children and young people: an umbrella review of meta-analyses.European child & adolescent psychiatry · 2026Pooled it
- A meta-analysis investigating the outcomes and correlation between heart rate variability biofeedback training on depressive symptoms and heart rate variability outcomes versus standard treatment in comorbid adult populations.Acta bio-medica : Atenei Parmensis · 2023Pooled it
- Adding cognitive therapy to antidepressant medications decreases suicidal ideation.Journal of affective disorders · 2021Trial
- Reproducible Gut Microbiome Alterations in Major Depressive Disorder: A Systematic Review of Taxonomic and Functional Findings.Epidemiologia (Basel, Switzerland) · 2026Review
- Are People Worse Off in a Mental Health Treatment Paradigm Where Medication Is Deemphasised? A Naturalistic Noninferiority Trial of an Initiative to Improve Patient Choice.The International journal of social psychiatry · 2026Article
- Genistein improves depression-like behavior in rats by regulating intestinal flora and altering glutamate gene expression.Current research in food science · 2025Article
- Understanding symptom profiles of depression with the PHQ-9 in a community sample using network analysis.European psychiatry : the journal of the Association of European Psychiatrists · 2024Article
- Investigating the Relationship between Electroconvulsive Therapy and Heart Rate Variability: A Systematic Review.Advanced biomedical research · 2023Review
- Fluoxetine treatment supports predictive validity of the three hit model of depression in male PACAP heterozygous mice and underpins the impact of early life adversity on therapeutic efficacy.Frontiers in endocrinology · 2022Article
- From Mental Health Industry to Humane Care. Suggestions for an Alternative Systemic Approach to Distress.International journal of environmental research and public health · 2021Review
- Moving toward a process-oriented perspective in the personalized treatment of depression.European archives of psychiatry and clinical neuroscience · 2021Article
- Validity of self-reporting depression in the Tabari cohort study population.Neuropsychopharmacology reports · 2020Article
- Schema therapy versus cognitive behavioral therapy versus individual supportive therapy for depression in an inpatient and day clinic setting: study protocol of the OPTIMA-RCT.BMC psychiatry · 2020Article
Corrections and comments
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Authors and funding
21 authors at 12 institutions in 6 countries.
Funding
Abstract
backgroundAntidepressant medication (ADM) and psychotherapy are effective treatments for major depressive disorder (MDD). It is unclear, however, if treatments differ in their effectiveness at the symptom level and whether symptom information can be utilised to inform treatment allocation. The present study synthesises comparative effectiveness information from randomised controlled trials (RCTs) of ADM versus psychotherapy for MDD at the symptom level and develops and tests the Symptom-Oriented Therapy (SOrT) metric for precision treatment allocation.
methodsFirst, we conducted systematic review and meta-analyses of RCTs comparing ADM and psychotherapy at the individual symptom level. We searched PubMed Medline, PsycINFO, and the Cochrane Central Register of Controlled Trials databases, a database specific for psychotherapy RCTs, and looked for unpublished RCTs. Random-effects meta-analyses were applied on sum-scores and for individual symptoms for the Hamilton Rating Scale for Depression (HAM-D) and Beck Depression Inventory (BDI) measures. Second, we computed the SOrT metric, which combines meta-analytic effect sizes with patients' symptom profiles. The SOrT metric was evaluated using data from the Munich Antidepressant Response Signature (MARS) study (n = 407) and the Emory Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study (n = 234).
resultsThe systematic review identified 38 RCTs for qualitative inclusion, 27 and 19 for quantitative inclusion at the sum-score level, and 9 and 4 for quantitative inclusion on individual symptom level for the HAM-D and BDI, respectively. Neither meta-analytic strategy revealed significant differences in the effectiveness of ADM and psychotherapy across the two depression measures. The SOrT metric did not show meaningful associations with other clinical variables in the MARS sample, and there was no indication of utility of the metric for better treatment allocation from PReDICT data.
conclusionsThis registered report showed no differences of ADM and psychotherapy for the treatment of MDD at sum-score and symptom levels. Symptom-based metrics such as the proposed SOrT metric do not inform allocation to these treatments, but predictive value of symptom information requires further testing for other treatment comparisons.
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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.