Prevalence of suicide attempt in individuals with major depressive disorder: a meta-analysis of observational surveys

2018 ◽  
Vol 49 (10) ◽  
pp. 1691-1704 ◽  
Author(s):  
Min Dong ◽  
Liang-Nan Zeng ◽  
Li Lu ◽  
Xiao-Hong Li ◽  
Gabor S. Ungvari ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Suicide Attempt ◽  
Depressive Disorder ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Lifetime Prevalence ◽  
Cochrane Library ◽  
Major Depressive ◽  
Study Region ◽  
Pooled Prevalence

AbstractBackgroundSuicide attempt (SA), which is one of the strongest predictors of completed suicide, is common in major depressive disorder (MDD) but its prevalence across epidemiological studies has been mixed. The aim of this comprehensive meta-analysis was to examine the pooled prevalence of SA in individuals with MDD.MethodsA systematic literature search was conducted in PubMed, Embase, PsycINFO, Web of Science and Cochrane Library from their commencement date until 27 December 2017. Original studies containing data on prevalence of SA in individuals with MDD were analyzed.ResultsIn all, 65 studies with a total of 27 340 individuals with MDD were included. Using the random effects model, the pooled lifetime prevalence of SA was 31% [95% confidence interval (CI) 27–34%], 1-year prevalence was 8% (95% CI 3–14%) and 1-month prevalence was 24% (95% CI 15–34%). Subgroup analyses revealed that the lifetime prevalence of SA was significantly associated with the patient setting, study region and income level, while the 1-month prevalence of SA was associated with only the patient setting.ConclusionThis meta-analysis confirmed that SA was common in individuals with MDD across the world. Careful screening and appropriate interventions should be implemented for SA in the MDD population.

Azapirone 5-HT1A receptor partial agonist treatment for major depressive disorder: systematic review and meta-analysis

2013 ◽  
Vol 44 (11) ◽  
pp. 2255-2269 ◽  
Author(s):  
T. Kishi ◽  
H. Y. Meltzer ◽  
Y. Matsuda ◽  
N. Iwata
Keyword(s):  
Systematic Review ◽  
Major Depressive Disorder ◽  
Side Effects ◽  
Depressive Disorder ◽  
Partial Agonist ◽  
Meta Analysis ◽  
Gastrointestinal Symptoms ◽  
Cochrane Library ◽  
Number Needed To Treat ◽  
Major Depressive

BackgroundA meta-analysis of the serotonin1A (5-HT1A) receptor partial agonist of the azapirone class as an anxiolytic drug for the treatment of major depressive disorder (MDD) has not previously been reported.MethodWe carried out a systematic review of the literature available in PubMed, the Cochrane Library database and PsycINFO up to 12 October 2013, and conducted a meta-analysis of randomized controlled trials (RCTs) comparing 5-HT1A agonists with placebo and RCTs of 5-HT1A agonist augmentation therapies for MDD treatment. We calculated the risk ratio (RR), number needed to treat (NNT)/number needed to harm (NNH) and 95% confidence intervals (CIs).ResultsFifteen RCTs comparing 5-HT1A agonists with placebo (total n = 2469, four studies with buspirone, seven with gepirone, three with ipsapirone and one with zalospirone) were identified. Pooled 5-HT1A agonists had significantly more responders (RR 0.74, 95% CI 0.65–083, p < 0.00001, NNT = 6, 12 trials, n = 1816) than placebo. Pooled 5-HT1A agonists were superior to placebo in discontinuation due to inefficacy (RR 0.49, p = 0.02, NNH = 16, p = 0.03, 10 trials, n = 1494) but were inferior to placebo in discontinuation due to side-effects (RR 1.88, p < 0.0001, NNH = 17, p = 0.001, 13 trials, n = 2196). However, all-cause discontinuation was similar in both groups (RR 0.99, p = 0.85, 14 trials, n = 2402). Four 5-HT1A agonist augmentation studies were identified (total n = 365, three buspirone studies and one tandospirone study). There were no statistically significant effects of 5-HT1A agonist augmentation therapies on response rate (RR 0.98, p = 0.85, four trials, n = 341). 5-HT1A agonist-related side-effects including gastrointestinal symptoms, dizziness, insomnia, palpitation, paresthesia and sweating were greater than with placebo (p < 0.00001 to p = 0.03).ConclusionsOur results suggest that 5-HT1A agonist has a more beneficial effect on MDD than placebo, but has several side-effects.

scholarly journals A network meta-analysis on the effectiveness and safety of acupuncture in treating patients with major depressive disorder

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hu Zhichao ◽  
Lam Wai Ching ◽  
Li Huijuan ◽  
Yao Liang ◽  
Wang Zhiyu ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Large Scale ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Meta Analysis ◽  
Alternative Therapy ◽  
Cochrane Library ◽  
Depression Symptoms ◽  
China National Knowledge Infrastructure ◽  
Major Depressive

AbstractAcupuncture is an important alternative therapy in treating major depressive disorder (MDD), but its efficacy and safety are still not well assessed. This study is the first network meta-analysis exploring the effectiveness and safety of acupuncture, common pharmacological treatments or other non-medication therapies for MDD. Eight databases including PubMed, Embase, Allied and Complementary Medicine Database, Cochrane Library, Wan Fang Data, China National Knowledge Infrastructure, China Biology Medicine disc, and Chongqing VIP Database were searched up to Jan 17, 2021. Articles were screened and selected by two reviewers independently. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the certainty of the evidence. A total of 71 eligible studies were included. The network analysis results indicated that the combined interventions of electro-acupuncture (EA) with selective serotonin reuptake inhibitors (SSRIs) and manual acupuncture (MA) with SSRIs were more effective in improving depression symptoms compared with acupuncture alone, pharmacological interventions alone, or other inactive groups. Among all the regimens, EA with SSRIs was found to have the highest effect in improving depression symptoms of MDD. In addition, there were slight differences in the estimations of the various treatment durations. The combination of acupuncture and serotonin-norepinephrine reuptake inhibitors (SNRIs) was found to be more effective than SNRIs alone. In conclusion, acupuncture and its combinations could be safe and effective interventions for MDD patients. EA with SSRIs seems to be the most effective intervention among the assessed interventions. Well-designed and large-scale studies with long-term follow-up should be conducted in the future.

scholarly journals Global hippocampal atrophy in major depressive disorder: a meta-analysis of magnetic resonance imaging studies

2018 ◽  
Vol 40 (4) ◽  
pp. 369-378 ◽  
Author(s):  
Marcelo Antônio Oliveira Santos ◽  
Lucas Soares Bezerra ◽  
Ana Rita Marinho Ribeiro Carvalho ◽  
Alessandra Mertens Brainer-Lima
Keyword(s):  
Magnetic Resonance Imaging ◽  
Major Depressive Disorder ◽  
Magnetic Resonance ◽  
Depressive Disorder ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Hippocampal Atrophy ◽  
Resonance Imaging ◽  
Major Depressive ◽  
Magnetic Resonance Imaging Mri

Abstract Introduction: Major depressive disorder (MDD), an incapacitating mental disorder, is characterized by episodes of at least 2 weeks of apparent changes in mood, cognition, and neurovegetative functions. Many neuroimaging studies using magnetic resonance imaging (MRI) have examined morphometric changes in patients with MDD, but the results are not conclusive. This study aims to review the literature and perform a meta-analysis on hippocampal volume (HcV) in patients with MDD. Methods: Studies on HcV in patients with MDD diagnosis were identified from major databases (MEDLINE, EMBASE, The Cochrane Library, Scopus, PsycINFO, and SciELO) using the search terms depression, major depressive disorder, MDD, unipolar, magnetic resonance imaging, MRI, and hippocampus. Results: A meta-analysis of 29 studies fulfilling specific criteria was performed. The sample included 1327 patients and 1004 healthy participants. The studies were highly heterogeneous with respect to age, sex, age of onset, and average illness duration. However, the pooled effect size of depression was significant in both hippocampi. MDD was associated with right (-0.43; 95% confidence interval [95%CI] −0.66 to −0.21) and left (-0.40; 95%CI −0.66 to −0.15) hippocampal atrophy. Conclusions: MDD seems to be associated with global HcV atrophy. Larger longitudinal follow-up studies designed to analyze the influence of sociodemographic variables on this relationship are required to yield better evidence about this topic.

Treatment Rate for Major Depressive Disorder in China: a Meta-Analysis of Epidemiological Studies

2019 ◽  
Vol 90 (4) ◽  
pp. 883-895 ◽  
Author(s):  
Han Qi ◽  
Qian-Qian Zong ◽  
Grace K. I. Lok ◽  
Wen-Wang Rao ◽  
Feng-Rong An ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Treatment Rate ◽  
Major Depressive

scholarly journals Qigong-Based Therapy for Treating Adults with Major Depressive Disorder: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 16 (5) ◽  
pp. 826 ◽  
Author(s):  
Lijuan Guo ◽  
Zhaowei Kong ◽  
Yanjie Zhang
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Depression Symptoms ◽  
Controlled Trials ◽  
Control Groups ◽  
Major Depressive ◽  
Randomized Controlled

This current meta-analysis review was conducted to examine the effectiveness of Qigong-based therapy on individuals with major depressive disorder. Six electronic databases (PubMed, PsycINFO, Cochrane Library, and Web of Science, Chinese National Knowledge Infrastructure, and Wangfang) were employed to retrieve potential articles that were randomized controlled trials. The synthesized effect sizes (Hedges’ g) were computerized to explore the effectiveness of Qigong-based therapy. Additionally, a moderator analysis was performed based on the control type. The pooled results indicated that Qigong-based therapy has a significant benefit on depression severity (Hedges’ g = −0.64, 95% CI −0.92 to −0.35, p < 0. 001, I2 = 41.73%). Specifically, Qigong led to significantly reduced depression as compared to the active control groups (Hedges’ g = −0.47, 95% CI −0.81 to −0.12, p = 0.01, I2 = 22.75%) and the passive control groups (Hedges’ g = −0.80, 95% CI −1.23 to −0.37, p < 0.01, I2 = 48.07%), respectively. For studies which reported categorical outcomes, Qigong intervention showed significantly improved treatment response rates (OR = 4.38, 95% CI 1.26 to 15.23, p = 0.02) and remission rates (OR = 8.52, 95% CI 1.91 to 37.98, p = 0.005) in comparison to the waitlist control group. Conclusions: Qigong-based exercises may be effective for alleviating depression symptoms in individuals with major depressive disorder. Future well-designed, randomized, controlled trials with large sample sizes are needed to confirm these findings.

Efficacy of the sequential integration of psychotherapy and pharmacotherapy in major depressive disorder: a preliminary meta-analysis

2010 ◽  
Vol 41 (2) ◽  
pp. 321-331 ◽  
Author(s):  
J. Guidi ◽  
G. A. Fava ◽  
M. Fava ◽  
G. I. Papakostas
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Meta Analysis ◽  
Antidepressant Drugs ◽  
Relative Advantage ◽  
Control Treatment ◽  
Cochrane Library ◽  
Major Depressive ◽  
Treatment As Usual ◽  
Sequential Administration

BackgroundPrevention of relapse and recurrence represents an important task in the successful treatment of major depressive disorder (MDD). The aim of this meta-analysis was to examine the efficacy of the sequential integration of psychotherapy and pharmacotherapy in reducing the risk of relapse and recurrence in MDD.MethodKeyword searches were conducted in Medline, EMBASE, PsycINFO and the Cochrane Library from inception of each database to December 2008. Randomized controlled trials examining the efficacy of the administration of psychotherapy after successful response to acute-phase pharmacotherapy in the treatment of adults with MDD were considered for inclusion in the meta-analysis.ResultsEight high-quality studies with 442 patients in a sequential treatment arm and 433 in a control treatment arm were included. The pooled risk ratio (RR) for relapse/recurrence was 0.797 [95% confidence interval (CI) 0.659–0.964] according to the random-effects model, suggesting a relative advantage in preventing relapse/recurrence for the sequential administration of treatments compared with control conditions. Performing subgroup analyses, we found a trend favoring psychotherapy during continuation of antidepressant drugs compared to antidepressants or treatment as usual (RR 0.842, 95% CI 0.674–1.051). Patients randomized to psychotherapy while antidepressants were discontinued were significantly less likely to experience relapse/recurrence compared to controls (RR 0.650, 95% CI 0.463–0.912).ConclusionsWe found evidence that the sequential integration of psychotherapy and pharmacotherapy is a viable strategy for preventing relapse and recurrence in MDD. In addition, our findings suggest that discontinuation of antidepressant drugs may be feasible when psychotherapy is provided.

Global variation in the prevalence and incidence of major depressive disorder: a systematic review of the epidemiological literature

2012 ◽  
Vol 43 (3) ◽  
pp. 471-481 ◽  
Author(s):  
A. J. Ferrari ◽  
A. J. Somerville ◽  
A. J. Baxter ◽  
R. Norman ◽  
S. B. Patten ◽  
...  
Keyword(s):  
Systematic Review ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Major Depressive ◽  
Middle Income ◽  
Pooled Prevalence ◽  
Low Middle Income Countries ◽  
Incidence Studies

BackgroundSummarizing the epidemiology of major depressive disorder (MDD) at a global level is complicated by significant heterogeneity in the data. The aim of this study is to present a global summary of the prevalence and incidence of MDD, accounting for sources of bias, and dealing with heterogeneity. Findings are informing MDD burden quantification in the Global Burden of Disease (GBD) 2010 Study.MethodA systematic review of prevalence and incidence of MDD was undertaken. Electronic databases Medline, PsycINFO and EMBASE were searched. Community-representative studies adhering to suitable diagnostic nomenclature were included. A meta-regression was conducted to explore sources of heterogeneity in prevalence and guide the stratification of data in a meta-analysis.ResultsThe literature search identified 116 prevalence and four incidence studies. Prevalence period, sex, year of study, depression subtype, survey instrument, age and region were significant determinants of prevalence, explaining 57.7% of the variability between studies. The global point prevalence of MDD, adjusting for methodological differences, was 4.7% (4.4–5.0%). The pooled annual incidence was 3.0% (2.4–3.8%), clearly at odds with the pooled prevalence estimates and the previously reported average duration of 30 weeks for an episode of MDD.ConclusionsOur findings provide a comprehensive and up-to-date profile of the prevalence of MDD globally. Region and study methodology influenced the prevalence of MDD. This needs to be considered in the GBD 2010 study and in investigations into the ecological determinants of MDD. Good-quality estimates from low-/middle-income countries were sparse. More accurate data on incidence are also required.

scholarly journals Comparative Efficacy and Acceptability of Anti-inflammatory Agents on Major Depressive Disorder: A Network Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiaoyi Hang ◽  
Yijie Zhang ◽  
Jingjing Li ◽  
Zhenzhen Li ◽  
Yi Zhang ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Randomized Clinical Trials ◽  
Remission Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Omega 3 ◽  
Major Depressive ◽  
Inflammatory Agent ◽  
Anti Inflammatory

Background: With the growing importance of research about the association between neuroinflammation and major depressive disorder (MDD), anti-inflammatory agents have been used as a new antidepressant therapy in clinical practice. We conducted a network meta-analysis (NMA) with up-to-date evidence to compare different anti-inflammatory agents for improving the treatment of MDD patients.Methods: To identify eligible randomized clinical trials, four databases (i.e, the Cochrane Library, Web of Science, PubMed and Embase) were searched from inception date to May 31, 2020. Anti-inflammatory agents were defined as non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, cytokine inhibitors, statins, pioglitazone, minocycline, N-acetylcysteine (NAC) and omega-3 fatty acid (Omega-3 FA). The main outcomes of this NMA were efficacy, acceptability and remission rate. Risk ratio (RR) was adopted for dichotomous outcomes, and the confidence interval (CI) was set at 95%. STATA 14.0 and R 3.6.3 were used to conduct the NMA. The study protocol was registered with PROSPERO (CRD42020182531).Results: A total of 39 studies, involving 2871 participants, were included in quantitative data synthesis. For efficacy, NSAIDs (RR=0.50, 95%CI: 0.26-0.73) and pioglitazone (RR=0.45, 95%CI: 0.20-0.84) were more favorable than placebo. With respect to acceptability, NSAIDs were more acceptable than placebo (RR=0.89, 95%CI: 0.77-0.99) and minocycline (RR=1.22, 95%CI: 1.03-1.49). For remission, NSAIDs were more superior than placebo (RR=0.48, 95%CI: 0.27-0.79) and Omega-3 FA (RR=2.01, 95%CI: 1.09-3.90), while NACs were more favorable than placebo (RR=0.39, 95%CI: 0.13-0.99). Based on the surface under the cumulative ranking curve (SUCRA) value, corticosteroids (0.86) were the best anti-inflammatory agent for MDD patients in terms of efficacy, but the head-to-head comparisons for the efficacy of glucocorticoids and other agents were not statistically significant. As for acceptability, NSAIDs (0.81) were much better than other anti-inflammatory agents. Besides, NAC (0.80) was the best anti-inflammatory agent in the terms of remission.Conclusions: In summary, we found that corticosteroids were more superior than other agents in terms of efficacy according to the SUCRA value. However, this result must be interpreted with caution because the head-to-head comparisons for the efficacy of glucocorticoids and other agents did not reach statistical significance. NSAIDs were recommended for acceptability and NAC for remission rate.

scholarly journals Association between serum lipid concentrations and attempted suicide in patients with major depressive disorder: A meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243847
Author(s):  
Huan Li ◽  
Xueyan Zhang ◽  
Qing Sun ◽  
Rui Zou ◽  
Zhijun Li ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Serum Lipid ◽  
Attempted Suicide ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cochrane Library ◽  
Serum Concentrations ◽  
Major Depressive

Background There is growing evidence that serum lipid concentrations may be associated with attempted suicide in patients with major depressive disorder (MDD), but these findings remain controversial. Thus, we performed a comprehensive meta-analysis to quantitatively assess the associations between serum lipid concentrations and attempted suicide in MDD patients. Materials and methods Electronic databases (PubMed, Embase, the Cochrane Library and the China National Knowledge Library) were searched for relevant literature up to 10 February 2020. We used a random-effects model based on heterogeneity amongst studies and generated pooled standardised mean differences (SMDs). Results Thirty-two studies comprising 7,068 subjects met the inclusion criteria. A pooled analysis showed that compared with non-attempters, MDD patients who had attempted suicide had significantly lower serum concentrations of total cholesterol (TC) (SMD: -0.63, 95% CI: -0.83 to -0.44) and low-density lipoprotein cholesterol (LDL-C) (SMD: -0.69, 95% CI: -1.04 to -0.34), but the serum concentrations of high-density lipoprotein cholesterol (HDL-C) (SMD: -0.12, 95% CI: -0.33 to 0.10) and triglycerides (TGs) (SMD: 0.00, 95% CI: -0.20 to 0.20) were not significantly different between the two groups. Subgroup and meta-regression analysis indicated that heterogeneity with respect to TC concentrations may be due to different ages (p = 0.041) and sample sizes (p = 0.016) of studies, and that heterogeneity with respect to HDL-C concentrations may be partly due to different settings of studies (p = 0.017). Conclusions This meta-analysis demonstrated that lower concentrations of TC and LDL-C, but not of HDL-C and TGs, were associated with attempted suicide in MDD patients. This indicates that TC and LDL-C may be useful as biological markers for predicting whether MDD patients may attempt to commit suicide.

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