Summary of findings 1. Antidepressant compared to placebo for psychotic depression.
| Antidepressant compared to placebo for psychotic depression | ||||||
| Patient or population: adults with psychotic depression Setting: hospital Intervention: antidepressant Comparison: placebo | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | №. of participants (studies) | Certainty of evidence (GRADE) | Comments | |
| Risk with placebo | Risk with antidepressant | |||||
| Clinical response of depression | Study population | RR 8.40 (0.50 to 142.27) | 27 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b,c | Study defined depression response as HRSD‐17 < 7 | |
| 36 per 1000 | 300 per 1000 (18 to 1000) | |||||
| Overall dropouts | Study population | RR 1.24 (0.34 to 4.51) | 27 (1 RCT) | ⊕⊝⊝⊝ Very lowa,b,c | ||
| 231 per 1000 | 286 per 1000 (78 to 1000) | |||||
| Depression remission | See comment | ‐ | ‐ | ‐ | No study reported this outcome | |
| Change in depression severity from baseline | See comment | ‐ | ‐ | ‐ | No study reported this outcome | |
| Quality of life | See comment | ‐ | ‐ | ‐ | No study reported this outcome | |
| Dropouts due to adverse effects | See comment | ‐ | ‐ | ‐ | No study reported this outcome | |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence. High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded one level for high risk of other bias.
bDowngraded one level for high risk of publication bias.
cDowngraded one level for imprecision due to small sample size; CIs are consistent with appreciable benefit and appreciable harm.