ArticleBMJ mental health2024
Estimating the smallest worthwhile difference of antidepressants: a cross-sectional survey.
Article in BMJ mental health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 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
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.
- Psychotherapy, Antidepressants, and Combined Treatment for Depression: A Network Meta-Analysis on Social Functioning Outcomes.Psychotherapy and psychosomatics · 2026Pooled it
- Efficacy and Moderators of Mindfulness-Based Cognitive Therapy in Difficult-to-Treat Depression: A Systematic Review and Individual Participant Data Meta-Analysis.Psychotherapy and psychosomatics · 2026Pooled it
- Bayesian probabilistic statements for communicating clinical trial results.BMC medicine · 2026Article
- Public acceptance and expectations for Lecanemab: Insights from a Smallest Worthwhile Difference study.Psychiatry and clinical neurosciences · 2026Article
- Pregnancy, Birth, Neonatal, and Mental Health Outcomes Are Minimally Associated with Pregnancy Ambivalence.Studies in family planning · 2026Article
- Producing treatment hierarchies in network meta-analysis using probabilistic models and treatment-choice criteria.Research synthesis methods · 2026Article
- Determining the smallest worthwhile difference of beta-3 agonist treatment for overactive bladder: a benefit-harm trade-off study.World journal of urology · 2026Article
- Psilocybin as a Disease-Modifying Drug—A Salutogenic Approach in Psychiatry.Deutsches Arzteblatt international · 2024Review
- Pregnancy, Birth, and Mental Health Outcomes Associated With Recent Reproductive Coercion and Intimate Partner Violence in a Crowd-Sourced National Sample.Journal of midwifery & women's healthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 8 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundApproximately 30% of patients experience substantial improvement in depression after 2 months without treatment, and 45% with antidepressants. The smallest worthwhile difference (SWD) refers to an intervention's smallest beneficial effect over a comparison patients deem worthwhile given treatment burdens (harms, expenses and inconveniences), but is undetermined for antidepressants.
objectiveEstimating the SWD of commonly prescribed antidepressants for depression compared to no treatment.
methodsThe SWD was estimated as a patient-required difference in response rates between antidepressants and no treatment after 2 months. An online cross-sectional survey using Prolific, MQ Mental Health and Amazon Mechanical Turk crowdsourcing services in the UK and USA between October 2022 and January 2023 garnered participants (N=935) that were a mean age of 44.1 (SD=13.9) and 66% women (n=617).
findingsOf 935 participants, 124 reported moderate-to-severe depressive symptoms but were not in treatment, 390 were in treatment and 495 reported absent-to-mild symptoms with or without treatment experiences. The median SWD was a 20% (IQR=10-30%) difference in response rates for people with moderate-to-severe depressive symptoms, not in treatment, and willing to consider antidepressants, and 25% (IQR=10-35%) for the full sample.
conclusionsOur observed SWDs mean that the current 15% antidepressant benefit over no treatment was sufficient for one in three people to accept antidepressants given the burdens, but two in three expected greater treatment benefits. IMPLICATIONS: While a minority may be satisfied with the best currently available antidepressants, more effective and/or less burdensome medications are needed, with more attention given to patient perspectives.
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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.