Evidence map›Paper›PMID 33849685›Full record

SynthesisPsychological medicine2021

The contribution of depressive 'disorder characteristics' to determinations of prognosis for adults with depression: an individual patient data meta-analysis.

Joshua E J Buckman, Rob Saunders, Zachary D Cohen, Phoebe Barnett, Katherine Clarke, Gareth Ambler, Robert J DeRubeis, Simon Gilbody, Steven D Hollon, Tony Kendrick and 11 more

Open access · hybridAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Psychological medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 5 pooled it
15.1field-weighted citation impact, top 1% of its field
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

34 citing papers in PubMed, 5 syntheses or guidelines pooled it, 79 citations in OpenAlex.

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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

21 authors at 11 institutions in 2 countries.

Joshua E J BuckmanCentre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, LondonWC1E 7HB, UK.ORCID 0000-0002-2281-0907
Rob SaundersCentre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, LondonWC1E 7HB, UK.
Zachary D CohenDepartment of Psychiatry, University of California, Los Angeles, Los Angeles, CA90095, USA.
Phoebe BarnettCentre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, LondonWC1E 7HB, UK.
Katherine ClarkeCentre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, LondonWC1E 7HB, UK.
Gareth AmblerStatistical Science, University College London, LondonWC1E 7HB, UK.
Robert J DeRubeisDepartment of Psychology, School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA19104-60185, USA.
Simon GilbodyDepartment of Health Sciences, University of York, YorkYO10 5DD, UK.
Steven D HollonDepartment of Psychology, Vanderbilt University, Nashville, TN37240, USA.
Tony KendrickPrimary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, SouthamptonSO16 5ST, UK.
Edward WatkinsDepartment of Psychology, University of Exeter, ExeterEX4 4QG, UK.
Nicola WilesCentre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, BristolBS8 2BN, UK.
David KesslerCentre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK.
David RichardsInstitute of Health Research, University of Exeter College of Medicine and Health, ExeterEX1 2LU, UK.
Deborah SharpCentre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK.
Sally BrabynDepartment of Health Sciences, University of York, YorkYO10 5DD, UK.
Elizabeth LittlewoodDepartment of Health Sciences, University of York, YorkYO10 5DD, UK.
Chris SalisburyCentre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, Bristol, UK.
Ian R WhiteMRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, LondonWC1V 6LJ, UK.
Glyn LewisDivision of Psychiatry, University College London, LondonW1T 7NF, UK.
Stephen PillingCentre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, LondonWC1E 7HB, UK.
Health Data Research UK · GBUniversity of Bristol · GBUniversity of York · GBUniversity of Exeter · GBMRC Clinical Trials Unit at UCL · GBRoyal Statistical Society · GBUniversity College London · GBUniversity of California, Los Angeles · USUniversity of Southampton · GBUniversity of the Arts · USVanderbilt University · US

Funding

Department of HealthMedical Research Council G0200243Medical Research Council G0701013Medical Research Council MC_UU_00004/06Medical Research Council MC_UU_12023/21Wellcome Trust 201292/Z/16/Z
6 · The paper itself

Abstract

backgroundThis study aimed to investigate general factors associated with prognosis regardless of the type of treatment received, for adults with depression in primary care.

methodsWe searched Medline, Embase, PsycINFO and Cochrane Central (inception to 12/01/2020) for RCTs that included the most commonly used comprehensive measure of depressive and anxiety disorder symptoms and diagnoses, in primary care depression RCTs (the Revised Clinical Interview Schedule: CIS-R). Two-stage random-effects meta-analyses were conducted.

resultsTwelve (n = 6024) of thirteen eligible studies (n = 6175) provided individual patient data. There was a 31% (95%CI: 25 to 37) difference in depressive symptoms at 3-4 months per standard deviation increase in baseline depressive symptoms. Four additional factors: the duration of anxiety; duration of depression; comorbid panic disorder; and a history of antidepressant treatment were also independently associated with poorer prognosis. There was evidence that the difference in prognosis when these factors were combined could be of clinical importance. Adding these variables improved the amount of variance explained in 3-4 month depressive symptoms from 16% using depressive symptom severity alone to 27%. Risk of bias (assessed with QUIPS) was low in all studies and quality (assessed with GRADE) was high. Sensitivity analyses did not alter our conclusions.

conclusionsWhen adults seek treatment for depression clinicians should routinely assess for the duration of anxiety, duration of depression, comorbid panic disorder, and a history of antidepressant treatment alongside depressive symptom severity. This could provide clinicians and patients with useful and desired information to elucidate prognosis and aid the clinical management of depression.

Indexed as

AdultAntidepressive AgentsAnxietyDepressionFemaleHumansMaleMiddle AgedPrognosisSeverity of Illness IndexYoung AdultAntidepressive AgentsDepressionindividual patient data meta-analysisprognosissystematic reviewtreatment outcome

Identifiers

PMID33849685
PMCPMC8188529
OpenAlexW3155185250

What OpenQuestion holds

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Registered trials

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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.