Table 4.
Summary of Meta-Analytic Findings from Controlled Trials for Continuation or Maintenance Treatments for Recurrent Major Depression
| Measures | Drug Continuation | Drug Maintenance | Psychosocial Maintenance |
|---|---|---|---|
| Reports | 45 | 35 | 17 |
| Controlled trials | 72 | 37 | 22 |
| Years | 1 973–2 014 | 1 983–2 012 | 1 992–2 011 |
| Subjects | |||
| Total | 14 450 | 7253 | 1 969 |
| Per trial | 189 (138–239) | 188 (131–245) | 124 (92.1–156) |
| Mean age | 48.3 (46.0–50.6) | 47.5 (42.5–52.1) | 44.6 (44.0–48.2) |
| % Women | 60.4 (56.4–64.4) | 69.5 (37.3–71.7) | 69.6 (64.7–75.5) |
| Duration (mos) | 8.35 (7.55–9.15) | 26.8 (25.5–31.1) | 23.7 (18.4–29.0) |
| RR (95% CI) | 1.90 (1.73–2.08) | 2.03 (1.80-2.28) | 1.39 (1.13–1.70) |
| z-score (p-value) | 13.3 (<0.0001) | 11.7 (<0.0001) | 3.15 (0.002) |
| NNT (95% CI) | 4.4 (3.8–5.2) | 3.8 (3.3–4.6) | 6.0 (3.8–14) |
| Trials with significant superiority of test treatment (%)* | 49/72 (68.1%) | 32/37 (86.5%) | 11/22 (50.0%) |
Recurrence rate (RR) is meta-analytically pooled risk of new depression with placebo or control treatment vs. active experimental treatment. Data are derived from Tables 1–3 and Supplementary Tables S1–3. *Success-rate is significantly greater for drug vs. psychosocial maintenance treatments (χ2 = 6.29, p = 0.01) and for all drug vs. psychosocial treatments (χ2 = 4.72, p = 0.03), but not between continuation and maintenance drug treatment (χ2 = 2.80, p = 0.09).
CI, confidence interval; NNT, number needed to treat to yield a selective response to drug > placebo.