ArticlePloS one2020
A register-based approach to identifying treatment-resistant depression-Comparison with clinical definitions.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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.
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
14 citing papers in PubMed.
- No effects on heart rate variability in depression after treatment with dorsomedial prefrontal intermittent theta burst stimulation.Upsala journal of medical sciences · 2023Trial
- Psychiatric outcomes and long-term school and work-related disability in offspring of parents with depression and treatment-resistant depression.Social psychiatry and psychiatric epidemiology · 2026Article
- Inflammatory Cytokines as a Shared Pathophysiological Pathway in Depression and Chronic Insomnia: A Narrative Review of Mechanisms and Clinical Implications.Neuropsychiatric disease and treatment · 2026Review
- Physical Therapy for Treatment-Resistant Depression A Comprehensive Review of Efficacy, Safety, and Evidence Grading.Neuropsychiatric disease and treatment · 2026Review
- Long-Term Use of Benzodiazepines and Related Drugs in Persons With Major Depressive Disorder.Brain and behavior · 2025Article
- Longitudinal associations between psychological factors, community integration, and suicide risks among patients with treatment-resistant depression in Vietnam.Frontiers in psychiatry · 2025Article
- Prospective study of antidepressant treatment of psychiatric patients with depressive disorders: treatment adequacy and outcomes.BMC psychiatry · 2023Article
- Exome-wide association study of treatment-resistant depression suggests novel treatment targets.Scientific reports · 2023Article
- The Individual and Societal Burden of Treatment-Resistant Depression: An Overview.The Psychiatric clinics of North America · 2023Review
- Response to electroconvulsive therapy in treatment-resistant depression: nationwide observational follow-up study.BJPsych open · 2023Article
- Healthcare utilization, costs, and productivity losses in treatment-resistant depression in Finland - a matched cohort study.BMC psychiatry · 2022Article
- Treatment-resistant depression and labor market affiliation in the Danish welfare society: a register-based study.Social psychiatry and psychiatric epidemiology · 2022Article
- Factors associated with antidepressant responses to repetitive transcranial magnetic stimulation in antidepressant-resistant depression.Frontiers in neuroscience · 2022Article
- Excess deaths in treatment-resistant depression.Therapeutic advances in psychopharmacology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral definitions of treatment-resistant depression (TRD) are used for clinical research, but no verified model for use in register data exists. We aimed to compare a novel model created for use in register data-the Karolinska Institutet Model (KIM)-to the clinical definitions regarding the proportion of patients identified with TRD, their characteristics and clinical outcomes.
methodsAll patients in Sweden initiating antidepressant treatment with a diagnosis of depression in specialized healthcare 2006-2014 were identified and followed in national registers. In KIM, patients who initiated a third sequential, >28-day antidepressant treatment trial were defined as having TRD. Proportion of TRD and patient characteristics were compared with register adaptations of the European Staging Model (ESM), Massachusetts General Hospital Staging Method (MGH-s), and Maudsley Staging Model (MSM). Differences in patient characteristics were assessed with Chi-square tests and one-way ANOVAs. Hazard ratios for psychiatric hospitalization and for death from external causes were estimated by Cox proportional hazard regressions.
resultsOut of 127,108 antidepressant initiators with depression, the highest proportion of TRD was found using the MGH-s (19.0%), followed by MSM (15.3%), KIM (12.9%), and ESM (9.5%). Clinical characteristics were similar across the models. Compared with TRD patients identified by KIM, those identified by ESM had a marginally higher risk for psychiatric hospitalization (adjusted hazard ratio [aHR] 1.03, 95%CI 1.00-1.05), whereas those identified by MGH-s (aHR 0.92; 0.90-0.94) and MSM (aHR 0.95; 0.94-0.97) had a slightly reduced risk. Patients identified by MGH-s showed a reduced mortality compared with KIM (aHR 0.84; 0.72-0.98).
conclusionsThis study provides insight into the differing characteristics of patients captured by various TRD models when used for register research. Models yielding lower proportions of TRD seemed to identify patients with greater morbidity. The KIM may be useful for register based research in TRD.
Indexed as
Identifiers
What OpenQuestion holds
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.