Evidence map›Paper›PMID 38017416›Full record

ArticleBMC psychiatry2023

Prospective study of antidepressant treatment of psychiatric patients with depressive disorders: treatment adequacy and outcomes.

Johanna von Knorring, Ilya Baryshnikov, Pekka Jylhä, Tiina Talaslahti, Martti Heikkinen, Erkki Isometsä

Open access · goldAbstract read
In one paragraph

Article in BMC psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 20% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Article
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

6 authors at 2 institutions in 1 country.

Johanna von KnorringDepartment of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22, Helsinki, FI-00014, Finland.
Ilya BaryshnikovDepartment of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22, Helsinki, FI-00014, Finland.
Pekka JylhäDepartment of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22, Helsinki, FI-00014, Finland.
Tiina TalaslahtiDepartment of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22, Helsinki, FI-00014, Finland.
Martti HeikkinenDepartment of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22, Helsinki, FI-00014, Finland.
Erkki IsometsäDepartment of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22, Helsinki, FI-00014, Finland. erkki.isometsa@hus.fi.
Helsinki University Hospital · FIUniversity of Helsinki · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite numerous national depression care guidelines (DCGs), suboptimal antidepressant treatment may occur. We examined DCG concordance and depression treatment outcomes in psychiatric settings.

methodsWe evaluated treatment received and outcomes of 128 psychiatric out- and inpatients participating in the PEGAD (Pharmacoepidemiology and Pharmacogenetics of Antidepressant Treatment for Depressive Disorders) study at baseline, two weeks, and eight weeks using interviews and questionnaires. Inclusion criteria were ICD-10 diagnosis of a depressive disorder, a Patient Health Questionnaire-9 symptom (PHQ-9) score ≥ 10, and a new antidepressant prescribed. The primary outcome of the study was within-individual change in PHQ-9 scores.

resultsAt baseline, patients had predominately recurrent (83%) and in 19% treatment-resistant depression (TRD). The median preceding duration of the current episode was 6.5 months. At eight weeks, 85% of the patients (n = 107) used a DCG-concordant antidepressant dose. However, due to the scarcity of antidepressant combinations and augmentations, fewer TRD than non-TRD patients (25% vs. 84%, p < 0.005) received adequate antidepressant treatment. Additionally, one-third of the patients received inadequate follow-up. Overall, only 53% received treatment compatible with DCG recommendations for adequate pharmacotherapy and follow-up. The mean decline in PHQ-9 scores (-3.8 ± SD 5.7) was significant (p < 0.0005). Nearly 40% of the patients reached a subthreshold level of depression (PHQ-9 < 10), predicted by a lower baseline PHQ-9 score, recurrent depression, and female sex. However, 45% experienced no significant clinical improvement (PHQ-9 score reduction < 20%).

conclusionsOur findings suggest that inadequate treatment continues to occur in psychiatric care settings, particularly for TRD patients.

Indexed as

Depressive Disorder, Treatment-ResistantMajor Depressive DisorderAntidepressive AgentsFemaleHumansProspective StudiesPsychotherapyTreatment OutcomeAntidepressive AgentsAntidepressantDepressionPsychiatric careTreatment adequacyTreatment outcome

Identifiers

PMID38017416
PMCPMC10683284
OpenAlexW4389086736

What OpenQuestion holds

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LicenceCC BY
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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.