Evidence map›Paper›PMID 41402234›Full record

ArticleEuropean psychiatry : the journal of the Association of European Psychiatrists2025

Modeling effect: How treatment intensity and duration impact depression recurrence.

Fang Li, Qingyang Shi, Ellen Visser, Robert A Schoevers, Talitha Feenstra, Frederike Jörg

Abstract read
In one paragraph

Article in European psychiatry : the journal of the Association of European Psychiatrists, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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.

Fang LiUniversity of Groningen, Faculty of Science and Engineering, Groningen Research Institute of Pharmacy, Groningen, the Netherlands.ORCID 0000-0002-2651-8401
Qingyang ShiUniversity of Groningen, Faculty of Science and Engineering, Groningen Research Institute of Pharmacy, Groningen, the Netherlands.
Ellen VisserUniversity of Groningen, University Medical Center Groningen, University Center Psychiatry, Rob Giel Research Center, Interdisciplinary Centre for Psychopathology and Emotion Regulation, the Netherlands.ORCID 0000-0002-6370-5484
Robert A SchoeversUniversity of Groningen, University Medical Center Groningen, University Center Psychiatry, Rob Giel Research Center, Interdisciplinary Centre for Psychopathology and Emotion Regulation, the Netherlands.
Talitha FeenstraUniversity of Groningen, Faculty of Science and Engineering, Groningen Research Institute of Pharmacy, Groningen, the Netherlands.ORCID 0000-0002-5788-0454
Frederike JörgUniversity of Groningen, University Medical Center Groningen, University Center Psychiatry, Rob Giel Research Center, Interdisciplinary Centre for Psychopathology and Emotion Regulation, the Netherlands.ORCID 0000-0003-1720-1231

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOptimizing depression treatment intensity and duration is crucial, given an overburdened mental healthcare system. However, decision-making is challenged by heterogeneous treatment effects. We aimed to investigate these effects, accounting for confounders and population heterogeneity, in a real-world dataset from specialized mental healthcare.

methodsThe study included 36,946 participants from mental healthcare providers in the Northern Netherlands. We measured the effects of treatment duration and intensity on time to depression recurrence, using monthly costs as a proxy for treatment intensity. An accelerated failure time model was used, adjusting for confounding via entropy weighting. Non-linear effects were examined using restricted cubic splines to identify turning points, after which linear analyses were stratified. Population heterogeneity was explored through K-means clustering analyses, followed by cluster-specific analyses.

resultsIn the high-intensity group (above €360/month), a €1000/month increase in treatment intensity may reduce time to recurrence by 16% (acceleration factor [AF] 0.84, 95% CI 0.77-0.92). Conversely, the same increase in the low-intensity group might prolong recurrence-free time by 9.6-fold (AF 9.6, 95% CI 2.18-42.31). Extending treatment duration by 6 months may reduce time to recurrence by 7% (AF 0.93, 95% CI 0.89-0.97) in the long-duration group, with no significant effect in the short-duration group. Five clusters emerged, three of which comprised only women, with AFs of 0.67, 0.80, and 0.81, respectively, under high treatment intensity.

conclusionsIncreasing treatment intensity appears worthwhile only in the low-intensity group, though residual confounding remains possible.

Indexed as

Antidepressive AgentsMajor Depressive DisorderAdultFemaleHumansMaleMiddle AgedNetherlandsRecurrenceTime FactorsAntidepressive Agentsdepression recurrenceindividualized treatmentreal-world datatreatment intensity

Identifiers

PMID41402234
PMCPMC12816926

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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.