Efficacy and acceptability of adjunctive psychological and pharmacological interventions for treatment-resistant depression: protocol for a systematic review and network meta-analysis.

辅助性心理与药物干预治疗难治性抑郁症的有效性与可接受性：系统评价与网状Meta分析方案

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ID: 69976
2019
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Abstract
Major depressive disorder (MDD) is a common debilitating illness worldwide. The vast majority of patients with MDD will not achieve remission with first-line treatment and despite the availability of different treatment modalities, at least one-third of patients experience treatment-resistant depression (TRD). There continues to be a paucity of research focused on treatment options for patients with TRD thus treatment decisions are largely based on patient and clinician preference as opposed to evidence-based practice. Herein we propose a systematic review and network meta-analysis (NMA) of available pharmacological and psychological augmentation treatments for TRD, to inform evidence-based management of TRD.We plan to conduct a search of electronic databases (MEDLINE and ISIWEB) of all dates from inception for randomised controlled trials of pharmacological and psychological augmentation interventions for adults with TRD. Articles for review will be included based upon consensus from two authors. Pharmaceutical companies will be contacted for access to any unpublished data. An NMA will compare the effectiveness pharmacological adjunctive agents for TRD using preanalysis/postanalysis, assuming consistency and transitivity.This project does not require research ethics board approval. The dissemination plan is to present findings at international scientific meetings and publishing results in a peer-reviewed academic journal.CRD42019132588.
重度抑郁症（MDD）是全球范围内一种常见的致残性疾病。绝大多数MDD患者无法通过一线治疗达到临床缓解；尽管目前存在多种不同的治疗方式，仍有至少三分之一的患者会发展为难治性抑郁症（TRD）。目前针对TRD患者治疗选择的研究仍然匮乏，因此临床治疗决策在很大程度上取决于患者和临床医生的偏好，而非基于循证实践。在此，我们拟针对现有的TRD药物及心理增效治疗开展一项系统评价与网状Meta分析（NMA），以期为TRD的循证管理提供依据。 我们计划检索自建库起至检索日期的电子数据库（MEDLINE和ISIWEB），以获取针对成人TRD患者药物和心理增效干预的随机对照试验。待审文献的纳入将基于两位作者的共识。我们将联系制药公司以获取所有未发表的数据。在满足一致性和传递性假设的前提下，本研究将通过NMA并采用分析前/分析后方法，比较TRD药物辅助治疗的有效性。 本项目无需研究伦理委员会批准。成果传播计划包括在国际学术会议上汇报研究发现，并在同行评审的学术期刊上发表研究成果。 CRD42019132588。
Reference Key
husain2019efficacybmj Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Muhammad Ishrat Husain, Rebecca Strawbridge, Ben Carter, Brett D M Jones, Allan Young, Andre F Carvalho
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Journal BMJ open
Year 2019
DOI
10.1136/bmjopen-2018-028538
URL
Keywords
adult psychiatry clinical pharmacology

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