Comparative efficacy and acceptability of antidepressants, psychological interventions, and their combination for depressive disorder in children and adolescents

protocol for a network meta-analysis

Xinyu Zhou, Andrea Cipriani, Yuqing Zhang, Pim Cuijpers, Sarah E Hetrick, John R Weisz, Juncai Pu, Cinzia Del Giovane, Toshiaki A Furukawa, Jürgen Barth, David Coghill, Stefan Leucht, Lining Yang, Arun V Ravindran, Peng Xie

    Research output: Contribution to journalArticle

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    Abstract

    Introduction: Depressive disorder is common in children and adolescents, with important consequences and serious impairments in terms of personal and social functioning. While both pharmacological and psychological interventions have been shown to be effective, there is still uncertainty about the balance between these and what treatment strategy should be preferred in clinical practice. Therefore, we aim to compare and rank in a network meta-analysis (NMA) the commonly used psychological, pharmacological and combined interventions for depressive disorder in children and adolescents.

    Methods and analysis: We will update the literature search of two previous NMAs for the identification of trials of antidepressant and psychotherapy alone for depressive disorder in children and adolescents. For identification of trials of combination interventions, seven databases (PubMed, EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), Web of Science, PsycINFO, CINAHL, LiLACS) will be searched from date of inception. We will also search ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform and check relevant reports on the US Food and Drug Administration website for unpublished data. Building on our previous findings in the field, we will include any commonly prescribed oral antidepressants and any manualised or structured psychotherapies, as well as their combinations. Randomised controlled trials assessing any active intervention against active comparator or pill placebo/psychological controls in acute treatment for depressive disorder in children and adolescents will be included. The primary outcomes will be efficacy (mean change in depressive symptoms), and acceptability of treatment (dropout rate due to any cause). The secondary outcomes will be remission rate, tolerability of treatment (dropouts for adverse events), as well as suicide-related outcomes (suicidal behaviour or ideation). We will perform Bayesian NMAs for all relative outcome measures. Subgroup analyses and sensitivity analyses will be conducted to assess the robustness of the findings.

    Dissemination: This NMA will provide the most up to date and clinically useful information about the comparative efficacy and acceptability of antidepressants, psychological intervention and their combination in the acute treatment of children and adolescents with depressive disorder. This is the newest NMA and therefore these results are very important in terms of evidence-based medicine. The results will be disseminated through peer-reviewed publication.

    Protocol registration: PROSPERO CRD42015020841.

    Original languageEnglish
    Article numbere016608
    Pages (from-to)1-9
    Number of pages9
    JournalBMJ Open
    Volume7
    Issue number8
    DOIs
    Publication statusPublished - 11 Aug 2017

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    Depressive Disorder
    Antidepressive Agents
    Psychology
    Psychotherapy
    Pharmacology
    Therapeutics
    Evidence-Based Medicine
    United States Food and Drug Administration
    PubMed
    Suicide
    Uncertainty
    Registries
    Publications
    Randomized Controlled Trials
    Placebos
    Outcome Assessment (Health Care)
    Network Meta-Analysis
    Clinical Trials
    Databases
    Depression

    Keywords

    • Journal Article

    Cite this

    Zhou, Xinyu ; Cipriani, Andrea ; Zhang, Yuqing ; Cuijpers, Pim ; Hetrick, Sarah E ; Weisz, John R ; Pu, Juncai ; Giovane, Cinzia Del ; Furukawa, Toshiaki A ; Barth, Jürgen ; Coghill, David ; Leucht, Stefan ; Yang, Lining ; Ravindran, Arun V ; Xie, Peng. / Comparative efficacy and acceptability of antidepressants, psychological interventions, and their combination for depressive disorder in children and adolescents : protocol for a network meta-analysis. In: BMJ Open. 2017 ; Vol. 7, No. 8. pp. 1-9.
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    abstract = "Introduction: Depressive disorder is common in children and adolescents, with important consequences and serious impairments in terms of personal and social functioning. While both pharmacological and psychological interventions have been shown to be effective, there is still uncertainty about the balance between these and what treatment strategy should be preferred in clinical practice. Therefore, we aim to compare and rank in a network meta-analysis (NMA) the commonly used psychological, pharmacological and combined interventions for depressive disorder in children and adolescents.Methods and analysis: We will update the literature search of two previous NMAs for the identification of trials of antidepressant and psychotherapy alone for depressive disorder in children and adolescents. For identification of trials of combination interventions, seven databases (PubMed, EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), Web of Science, PsycINFO, CINAHL, LiLACS) will be searched from date of inception. We will also search ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform and check relevant reports on the US Food and Drug Administration website for unpublished data. Building on our previous findings in the field, we will include any commonly prescribed oral antidepressants and any manualised or structured psychotherapies, as well as their combinations. Randomised controlled trials assessing any active intervention against active comparator or pill placebo/psychological controls in acute treatment for depressive disorder in children and adolescents will be included. The primary outcomes will be efficacy (mean change in depressive symptoms), and acceptability of treatment (dropout rate due to any cause). The secondary outcomes will be remission rate, tolerability of treatment (dropouts for adverse events), as well as suicide-related outcomes (suicidal behaviour or ideation). We will perform Bayesian NMAs for all relative outcome measures. Subgroup analyses and sensitivity analyses will be conducted to assess the robustness of the findings.Dissemination: This NMA will provide the most up to date and clinically useful information about the comparative efficacy and acceptability of antidepressants, psychological intervention and their combination in the acute treatment of children and adolescents with depressive disorder. This is the newest NMA and therefore these results are very important in terms of evidence-based medicine. The results will be disseminated through peer-reviewed publication.Protocol registration: PROSPERO CRD42015020841.",
    keywords = "Journal Article",
    author = "Xinyu Zhou and Andrea Cipriani and Yuqing Zhang and Pim Cuijpers and Hetrick, {Sarah E} and Weisz, {John R} and Juncai Pu and Giovane, {Cinzia Del} and Furukawa, {Toshiaki A} and J{\"u}rgen Barth and David Coghill and Stefan Leucht and Lining Yang and Ravindran, {Arun V} and Peng Xie",
    note = "Funding: This work is supported by the National Basic Research Program of China (973 Program) (Grant No. 2009CB918300).",
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    Zhou, X, Cipriani, A, Zhang, Y, Cuijpers, P, Hetrick, SE, Weisz, JR, Pu, J, Giovane, CD, Furukawa, TA, Barth, J, Coghill, D, Leucht, S, Yang, L, Ravindran, AV & Xie, P 2017, 'Comparative efficacy and acceptability of antidepressants, psychological interventions, and their combination for depressive disorder in children and adolescents: protocol for a network meta-analysis', BMJ Open, vol. 7, no. 8, e016608, pp. 1-9. https://doi.org/10.1136/bmjopen-2017-016608

    Comparative efficacy and acceptability of antidepressants, psychological interventions, and their combination for depressive disorder in children and adolescents : protocol for a network meta-analysis. / Zhou, Xinyu; Cipriani, Andrea; Zhang, Yuqing; Cuijpers, Pim; Hetrick, Sarah E; Weisz, John R; Pu, Juncai; Giovane, Cinzia Del; Furukawa, Toshiaki A; Barth, Jürgen; Coghill, David; Leucht, Stefan; Yang, Lining; Ravindran, Arun V; Xie, Peng.

    In: BMJ Open, Vol. 7, No. 8, e016608, 11.08.2017, p. 1-9.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Comparative efficacy and acceptability of antidepressants, psychological interventions, and their combination for depressive disorder in children and adolescents

    T2 - protocol for a network meta-analysis

    AU - Zhou, Xinyu

    AU - Cipriani, Andrea

    AU - Zhang, Yuqing

    AU - Cuijpers, Pim

    AU - Hetrick, Sarah E

    AU - Weisz, John R

    AU - Pu, Juncai

    AU - Giovane, Cinzia Del

    AU - Furukawa, Toshiaki A

    AU - Barth, Jürgen

    AU - Coghill, David

    AU - Leucht, Stefan

    AU - Yang, Lining

    AU - Ravindran, Arun V

    AU - Xie, Peng

    N1 - Funding: This work is supported by the National Basic Research Program of China (973 Program) (Grant No. 2009CB918300).

    PY - 2017/8/11

    Y1 - 2017/8/11

    N2 - Introduction: Depressive disorder is common in children and adolescents, with important consequences and serious impairments in terms of personal and social functioning. While both pharmacological and psychological interventions have been shown to be effective, there is still uncertainty about the balance between these and what treatment strategy should be preferred in clinical practice. Therefore, we aim to compare and rank in a network meta-analysis (NMA) the commonly used psychological, pharmacological and combined interventions for depressive disorder in children and adolescents.Methods and analysis: We will update the literature search of two previous NMAs for the identification of trials of antidepressant and psychotherapy alone for depressive disorder in children and adolescents. For identification of trials of combination interventions, seven databases (PubMed, EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), Web of Science, PsycINFO, CINAHL, LiLACS) will be searched from date of inception. We will also search ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform and check relevant reports on the US Food and Drug Administration website for unpublished data. Building on our previous findings in the field, we will include any commonly prescribed oral antidepressants and any manualised or structured psychotherapies, as well as their combinations. Randomised controlled trials assessing any active intervention against active comparator or pill placebo/psychological controls in acute treatment for depressive disorder in children and adolescents will be included. The primary outcomes will be efficacy (mean change in depressive symptoms), and acceptability of treatment (dropout rate due to any cause). The secondary outcomes will be remission rate, tolerability of treatment (dropouts for adverse events), as well as suicide-related outcomes (suicidal behaviour or ideation). We will perform Bayesian NMAs for all relative outcome measures. Subgroup analyses and sensitivity analyses will be conducted to assess the robustness of the findings.Dissemination: This NMA will provide the most up to date and clinically useful information about the comparative efficacy and acceptability of antidepressants, psychological intervention and their combination in the acute treatment of children and adolescents with depressive disorder. This is the newest NMA and therefore these results are very important in terms of evidence-based medicine. The results will be disseminated through peer-reviewed publication.Protocol registration: PROSPERO CRD42015020841.

    AB - Introduction: Depressive disorder is common in children and adolescents, with important consequences and serious impairments in terms of personal and social functioning. While both pharmacological and psychological interventions have been shown to be effective, there is still uncertainty about the balance between these and what treatment strategy should be preferred in clinical practice. Therefore, we aim to compare and rank in a network meta-analysis (NMA) the commonly used psychological, pharmacological and combined interventions for depressive disorder in children and adolescents.Methods and analysis: We will update the literature search of two previous NMAs for the identification of trials of antidepressant and psychotherapy alone for depressive disorder in children and adolescents. For identification of trials of combination interventions, seven databases (PubMed, EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), Web of Science, PsycINFO, CINAHL, LiLACS) will be searched from date of inception. We will also search ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform and check relevant reports on the US Food and Drug Administration website for unpublished data. Building on our previous findings in the field, we will include any commonly prescribed oral antidepressants and any manualised or structured psychotherapies, as well as their combinations. Randomised controlled trials assessing any active intervention against active comparator or pill placebo/psychological controls in acute treatment for depressive disorder in children and adolescents will be included. The primary outcomes will be efficacy (mean change in depressive symptoms), and acceptability of treatment (dropout rate due to any cause). The secondary outcomes will be remission rate, tolerability of treatment (dropouts for adverse events), as well as suicide-related outcomes (suicidal behaviour or ideation). We will perform Bayesian NMAs for all relative outcome measures. Subgroup analyses and sensitivity analyses will be conducted to assess the robustness of the findings.Dissemination: This NMA will provide the most up to date and clinically useful information about the comparative efficacy and acceptability of antidepressants, psychological intervention and their combination in the acute treatment of children and adolescents with depressive disorder. This is the newest NMA and therefore these results are very important in terms of evidence-based medicine. The results will be disseminated through peer-reviewed publication.Protocol registration: PROSPERO CRD42015020841.

    KW - Journal Article

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    DO - 10.1136/bmjopen-2017-016608

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    JO - BMJ Open

    JF - BMJ Open

    SN - 2044-6055

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