SynthesisBMJ mental health2025
Comparing apples and oranges in youth depression treatments? A quantitative critique of the evidence base and guidelines.
Synthesis in BMJ mental health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis 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
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparing apples and oranges in youth depression treatments? A quantitative critique of the evidence base and guidelines.BMJ mental health · 2025Pooled it
- Child and adolescent psychiatry: challenges, solutions, opportunities, and future directions.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026Article
- A critical appraisal of integrating family constellation therapy with pharmacological treatment for depression.Frontiers in psychiatry · 2026Review
- Article
- Mental health of children and young people in the WHO Europe region.The Lancet regional health. Europe · 2025Review
- School-based group interpersonal therapy for adolescents with depression in nepal: protocol for a phase III realist cluster-randomised controlled trial.BMC psychiatry · 2025Article
- Advancing the evidence base for child and adolescent psychopharmacology.BMJ mental health · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
objectivesShould a young person receive psychotherapy or medication for their depression and on what evidence do we base this decision? In this paper, we test the factors across modalities that may influence comparability between medication and psychotherapy trials.
methodsWe included 92 randomised controlled trials (RCTs) of psychotherapy and medication for child and adolescent depression (mean age 4-18 years). Using meta-analyses, we compared (a) participant characteristics and (b) trial characteristics in medication and psychotherapy trials. Lastly, we examined whether psychotherapy controls are well-matched to active conditions.
resultsParticipants in medication RCTs had higher depression severity and were more frequently male compared with psychotherapy RCTs. There was a dramatic difference in the within-subject improvement due to placebo (SMD=-1.9 (95% CI: -2.1 to -1.7)) vs. psychotherapy controls (SMD=-0.6 (95% CI: -0.9 to -0.3)). Within psychotherapy RCTs, control conditions were less intensive on average than active conditions.
conclusionsMedication and psychotherapy RCTs differ on fundamental participant and methodological characteristics, thereby raising questions about their comparability. Psychotherapy controls often involve little therapist contact and are easy-to-beat comparators. These findings cast doubt on the confidence with which psychotherapy is recommended for youth depression and highlight the pressing need to improve the evidence base.
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.