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A systematic review...
A systematic review and meta-analysis of maintenance treatment for psychotic depression
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- Al-Wandi, Ahmed, 1990- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,University Health Care Research Centre
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- Holmberg, C. (author)
- School of Medical Sciences, Örebro University, Örebro, Sweden
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- Landén, Mikael, 1966 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för psykiatri och neurokemi,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry,Institute of Neuroscience and Physiology, the Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
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- Nordenskjöld, Axel, 1977- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,University Health Care Research Centre
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(creator_code:org_t)
- 2021-10-19
- 2022
- English.
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In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 76:6, s. 442-450
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Abstract
Subject headings
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- Purpose To perform a systematic review on the use of maintenance treatment to prevent relapse and recurrence in patients with psychotic unipolar or bipolar depression. Methods We conducted an electronic search in December 2019 (and an updated search in July 2021) of four databases (PubMed, Embase, PsycINFO, and Cochrane) to identify controlled studies comparing the relapse rates of patients receiving maintenance treatment for psychotic unipolar depression and psychotic bipolar depression. A meta-analysis was made that included three studies comparing antidepressant (AD) and antipsychotic (AP) combination therapy with AD monotherapy. We used the GRADE tool to assess the quality of evidence. Results We included five randomized controlled trials fulfilling the inclusion criteria, making three comparisons: (a) AD + AP versus AD monotherapy; (b) AD + AP versus AP monotherapy; (c) AD + electroconvulsive therapy versus AD monotherapy. The included studies only examined patients with psychotic unipolar depression. The largest included study reported a statistically significant advantage of AD + AP compared with AD monotherapy. We made a meta-analysis of the three studies comparing AD + AP combination therapy with AD monotherapy, which included 195 patients and 56 events. The meta-analysis did not show a statistically significant difference between these treatments. Conclusions Contrary to the finding of the largest study, we did not find a statistically significant difference between AD + AP combination therapy and AD monotherapy in the meta-analysis. There is insufficient evidence to support the superiority of any treatment modality as maintenance treatment for psychotic depression. Further studies are required.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
Keyword
- Antidepressive agents
- antipsychotic agents
- depressive disorder
- major
- recurrence
- meta-analysis
- electroconvulsive-therapy
- major depression
- double-blind
- risperidone
- augmentation
- delusional depression
- bipolar depression
- relapse
- prevention
- disorder
- placebo
- antidepressants
- Psychiatry
- Antidepressive agents
Publication and Content Type
- ref (subject category)
- art (subject category)
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