Evidence map›Paper›PMID 32666210›Full record

SynthesisSocial psychiatry and psychiatric epidemiology2020

Social inequalities in antidepressant treatment outcomes: a systematic review.

Deeksha Elwadhi, Alex Cohen

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Social psychiatry and psychiatric epidemiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 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.

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

20 citing papers in PubMed, 1 synthesis or guideline pooled it.

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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

2 authors.

Deeksha ElwadhiCentral Locality Team, Haringey Adult Mental Health Services, St Ann's Hospital, Barnet, Enfield and Haringey Mental Health Trust, London, UK. elwadhideeksha@gmail.com.ORCID http://orcid.org/0000-0002-9456-2113
Alex CohenDept of Epidemiology, Harvard-TH Chan School of Public Health, Boston, MA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo identify, review and synthesize evidence on whether social disadvantage moderates antidepressant treatment outcomes, even when access to treatment is not a consideration.

methodsThe systematic review was done in accordance with PRIMSA guidelines. An a priori systematic search strategy was used to search databases (MEDLINE, PsychINFO, EMBASE, Global Health and Cochrane Trials Library) from their earliest entries through December 31, 2018. A two-step screening procedure was followed, and all experimental studies of antidepressant treatment in ICD/DSM diagnosed cases of depression were included. Studies with subjects < 18 years or investigating other modalities of treatment were excluded.

resultsThirteen papers reporting analyses from nine studies met inclusion criteria. There was heterogeneity in sample sizes, target populations, treatment settings, clinical outcomes and definition of SES indices. The primary outcome was the relative effect of socioeconomic status (SES) (as measured by income, employment status and level of education)-on antidepressant treatment outcomes.

conclusionsThe evidence from this review suggests that lower SES may lead to social inequalities in antidepressant treatment outcomes even in the context of clinical trials in which all participants have equal access to the same high-quality, standardized care. The review calls for more careful consideration of the choice and operationalization of SES indicators, and the need to "employ sampling methods that ensure ample representation of individuals from a wide range of social worlds". The review concludes with tentative suggestions about how to reduce social inequalities in antidepressant treatment outcomes at the level of individuals and populations.

Indexed as

Antidepressive AgentsEmploymentHealth Services Needs and DemandHumansMental DisordersSocioeconomic FactorsTreatment OutcomeAntidepressive AgentsAntidepressantsEducationEmploymentIncomeSystematic review

Identifiers

What OpenQuestion holds

Textmetadata
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.