ReviewDepression and anxiety2021
Treatment-resistant major depressive disorder: Canadian expert consensus on definition and assessment.
Review in Depression and anxiety, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 7 of them syntheses that pooled 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.
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
48 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Reappraising lithium, triiodothyronine and second-generation antipsychotic augmentation treatment for major depression: a systematic review and meta-analysis with bias-adjustment analyses.BMJ mental health · 2026Pooled it
- Early or recent trauma in treatment-resistant depression: a systematic review.CNS spectrums · 2025Pooled it
- Structural and functional features of treatment-resistant depression: A systematic review and exploratory coordinate-based meta-analysis of neuroimaging studies.Psychiatry and clinical neurosciences · 2023Pooled it
- Systematic review and meta-analysis of augmentation and combination treatments for early-stage treatment-resistant depression.Journal of psychopharmacology (Oxford, England) · 2023Pooled it
- Guidelines' recommendations for the treatment-resistant depression: A systematic review of their quality.PloS one · 2023Pooled it
- Association between the BDNF Val66Met polymorphism and major depressive disorder: a systematic review and meta-analysis.Frontiers in psychiatry · 2023Pooled it
- Place of the partial dopamine receptor agonist aripiprazole in the management of schizophrenia in adults: a Delphi consensus study.BMC psychiatry · 2022Pooled it
- Treatment-resistant Depression in the Post-ketamine Era: Unmet Needs beyond Rapid Response.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2026Review
- Association Between Mental Health Literacy and Its Dimensions with Adolescent Depression and Anxiety: A Cross-Sectional Study Among 5759 Adolescents in China.Behavioral sciences (Basel, Switzerland) · 2026Article
- The relationship between uploader identity and the quality and reliability of depression-related Chinese short videos on TikTok and Bilibili.Frontiers in digital health · 2026Article
- Influence of the Big Five personality traits and the Wuxing of traditional Chinese medicine on depression in adolescents.Journal of education and health promotion · 2026Article
- Physical Therapy for Treatment-Resistant Depression A Comprehensive Review of Efficacy, Safety, and Evidence Grading.Neuropsychiatric disease and treatment · 2026Review
- Development and Evaluation of an Evidence-Based Management Indicator System for Transitional Care in Preterm Infants Using a Delphi and AHP Approach.Journal of nursing management · 2026Article
- From Monoamines to Systems Psychiatry: Rewiring Depression Science and Care (1960s-2025).Biomedicines · 2025Article
- Prevalence and Associated Factors for Depression Among Patients With Sarcoma.JCO oncology practice · 2025Article
- Factors associated with drug-drug interactions involving citalopram in the UK Biobank.BJPsych open · 2025Article
- Neurobiological Mechanisms of Electroconvulsive Therapy: Molecular Perspectives of Brain Stimulation.International journal of molecular sciences · 2025Review
- Integrative analysis of signaling and metabolic pathways, immune infiltration patterns, and machine learning-based diagnostic model construction in major depressive disorder.Scientific reports · 2025Article
- Emerging Medications for Treatment-Resistant Depression: A Review with Perspective on Mechanisms and Challenges.Brain sciences · 2025Review
- Spravato for Treatment-Resistant Depression: Efficacy and Sexual Side Effect Profile.Neuropsychiatric disease and treatment · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTreatment-resistant depression (TRD) is a debilitating chronic mental illness that confers increased morbidity and mortality, decreases the quality of life, impairs occupational, social, and offspring development, and translates into increased costs on the healthcare system. The goal of this study is to reach an agreement on the concept, definition, staging model, and assessment of TRD.
methodsThis study involved a review of the literature and a modified Delphi process for consensus agreement. The Appraisal of Guidelines for Research & Evaluation II guidelines were followed for the literature appraisal. Literature was assessed for quality and strength of evidence using the grading, assessment, development, and evaluations system. Canadian national experts in depression were invited for the modified Delphi process based on their prior clinical and research expertize. Survey items were considered to have reached a consensus if 80% or more of the experts supported the statement.
resultsFourteen Canadian experts were recruited for three rounds of surveys to reach a consensus on a total of 27 items. Experts agreed that a dimensional definition for treatment resistance was a useful concept to describe the heterogeneity of this illness. The use of staging models and clinical scales was recommended in evaluating depression. Risk factors and comorbidities were identified as potential predictors for treatment resistance.
conclusionsTRD is a meaningful concept both for clinical practice and research. An operational definition for TRD will allow for opportunities to improve the validity of predictors and therapeutic options for these patients.
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