Summary of findings for the main comparison. Medication compared to placebo for preventing relapse and recurrence of a depressive disorder in children and adolescents.
| Medication compared to placebo for preventing relapse and recurrence of a depressive disorder in children and adolescents | ||||||
| Patient or population: patients with preventing relapse and recurrence of a depressive disorder in children and adolescents Settings: outpatient Intervention: medication Comparison: placebo | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Placebo | Medication | |||||
| Number relapsed‐recurred | 667 per 1000 | 405 per 1000 (265 to 561) | OR 0.34 (0.18 to 0.64) | 164 (3 studies) | ⊕⊕⊕⊝ moderate2 | |
| Suicide‐related behaviours | 12 per 1000 | 13 per 1000 (2 to 85) | OR 1.02 (0.14 to 7.39) | 164 (3 studies) | ⊕⊕⊝⊝ low2,3 | |
| Drop‐outs | 259 per 1000 | 263 per 1000 (117 to 494) | OR 1.02 (0.38 to 2.79) | 164 (3 studies) | ⊕⊕⊕⊝ moderate3,4 | |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (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; OR: Odds ratio | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 For allocation concealment, three trials contained unclear risk of bias. In more than one trial there was insufficient evidence to rate blinding of participants and/or interviewers. 2 In all three trials there was 'unclear' risk of bias pertaining to allocation concealment, and in two trials there was insufficient information to deduce if assessors and participants were adequately blinded to treatment condition. 3 Total number of events is less than 300. 4 All trials adequately reported on number of drop‐outs and reasons.