Ceiling effects in the "Effectiveness of adjunctive antidepressant treatment for bipolar depression" study: was the sky the limit?

Brunoni, André R.

doi:10.1590/s1516-44462011000100022

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Therefore, future studies testing the effects of forest therapy need to include a higher level or dosage of therapeutic component of forest therapy. Another possible reason for the not-significant effect of forest therapy on improving depression in healthy adults is ceiling effect [42]. For future studies, well-thought-out intervention contents and careful selection of the outcome measures and target population are recommended.…”

Section: Discussionmentioning

confidence: 99%

Effects of Forest Therapy on Depressive Symptoms among Adults: A Systematic Review

Lee

Choi

Bang

et al. 2017

IJERPH

137

135

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This study systematically reviewed forest therapy programs designed to decrease the level of depression among adults and assessed the methodological rigor and scientific evidence quality of existing research studies to guide future studies. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors independently screened full-text articles from various databases using the following criteria: (1) intervention studies assessing the effects of forest therapy on depressive symptoms in adults aged 18 years and older; (2) studies including at least one control group or condition; (3) peer-reviewed studies; and (4) been published either in English or Korean before July 2016. The Scottish Intercollegiate Guideline Network measurement tool was used to assess the risk of bias in each trial. In the final sample, 28 articles (English: 13, Korean: 15) were included in the systematic review. We concluded that forest therapy is an emerging and effective intervention for decreasing adults’ depression levels. However, the included studies lacked methodological rigor. Future studies assessing the long-term effect of forest therapy on depression using rigorous study designs are needed.

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Section: Discussionmentioning

confidence: 99%

Effects of Forest Therapy on Depressive Symptoms among Adults: A Systematic Review

Lee

Choi

Bang

et al. 2017

IJERPH

137

135

View full text Add to dashboard Cite

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Time to lack of persistence with pharmacological treatment among patients with current depressive episodes: a natural study with 1-year follow-up

Li¹,

Wei²,

Li³

et al. 2016

PPA

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IntroductionMedication nonadherence remains a big challenge for depressive patients. This study aims to assess and compare the medication persistence between unipolar depression (UD) and bipolar depression (BD).MethodsA total of 146 UD and 187 BD patients were recruited at their first index prescription. Time to lack of persistence with pharmacological treatment (defined as a gap of at least 60 days without taking any medication) was calculated, and clinical characteristics were collected. Final diagnosis was made at the end of 1-year follow-up.ResultsA total of 101 (69.2%) UD and 126 (67.4%) BD patients discontinued the treatment, with a median duration of 36 days and 27 days, respectively. No significant difference was found between UD and BD in terms of time to lack of persistence with pharmacological treatment. The highest discontinuation rate (>40%) occurred in the first 3 months for both groups of patients. For UD patients, those with a higher risk of suicide (odds ratio [OR] =0.696, P=0.035) or comorbidity of any anxiety disorder (OR =0.159, P<0.001) were less likely to prematurely drop out (drop out within the first 3 months), while those with onset in the summer (OR =4.702, P=0.049) or autumn (OR =7.690, P=0.012) were more likely to prematurely drop out than those with onset in the spring (OR =0.159, P<0.001). For BD patients, being female (OR =2.250, P=0.012) and having a history of spontaneous remission or switch to hypomania (OR =2.470, P=0.004) were risk factors for premature drop out, while hospitalization (OR =0.304, P=0.023) and misdiagnosis as UD (OR =0.283, P<0.001) at the first index prescription were protective factors.LimitationConservative definition of nonadherence, low representativeness of sample.ConclusionTreatment discontinuation was frequently seen in patients with UD or BD, especially in the first 3 months of treatment. In spite of the similar pattern of medication persistence, UD and BD differ from each other in predictors of premature drop out.

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Ceiling effects in the "Effectiveness of adjunctive antidepressant treatment for bipolar depression" study: was the sky the limit?

Cited by 2 publications

References 6 publications

Effects of Forest Therapy on Depressive Symptoms among Adults: A Systematic Review

Effects of Forest Therapy on Depressive Symptoms among Adults: A Systematic Review

Time to lack of persistence with pharmacological treatment among patients with current depressive episodes: a natural study with 1-year follow-up

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