Study eligibility criteria: populations, interventions, comparators, outcomes, timing and settings for the review of reviews (PICOTS)
| PICOTS | Specific inclusion or exclusion criteria |
| Population | Adult (18 years and above) patients of all races and ethnicities with MDD who are undergoing first-step treatment during acute treatment phase. We did not include populations with bipolar disorder, perinatal depression, dysthymia, seasonal affective disorder or subsyndromal depression. We also did not include populations exclusively comprising patients with medical comorbidities and depression (eg, populations with heart disease and depression or with cancer and depression) |
| Interventions | Eligible interventions had to be used as an initial monotherapy for acute-phase MDD Psychological and behavioural interventions •Behaviour therapy/behaviour modification •Cognitive behavioural therapy •Third wave cognitive behavioural therapies •Psychodynamic therapies •Humanistic therapies •Integrative therapies •Systemic therapies •Other psychologically oriented interventions Somatic treatments •Any physical exercise •Light therapy •Tai Chi/Qigong •Yoga CAM therapies •Dietary supplements (eg, S-adenosyl-L-methionine (SAMe), omega-3 fatty acids) •Herbal remedies (eg, St John’s wort, Chinese herbal formulations) •Other CAM therapies used for the treatment of depression (eg, acupuncture) Pharmacological interventions •Second-generation antidepressants •Tricyclic antidepressants •Off-label pharmacological treatments We did not include combination treatments |
| Comparators | •Any inactive intervention (eg, placebo, waiting list, sham acupuncture, no care) •Second-generation antidepressants (agomelatine, bupropion, citalopram, desvenlafaxine, duloxetine, fluoxetine, escitalopram, fluvoxamine, levomilnacipran, mirtazapine, nefazodone, paroxetine, sertraline, trazodone, venlafaxine, vilazodone, vortioxetine) We did not include treatment as usual as a comparator because it is not standardised and cannot be considered an inactive intervention. |
| Outcomes | Efficacy and effectiveness: response, change of depression scores Adverse events (safety and tolerability): overall discontinuation, discontinuation because of adverse events |
| Timing | No restrictions |
| Setting | All settings |
| Time period | Articles published in 2011 and later |
| Study design | Systematic reviews* and meta-analyses (if based on a systematic review) of RCTs published in English, German or Italian languages |
*Systematic reviews are defined based on the Cochrane handbook as a literature review that attempts to collate all empirical evidence using (a) clearly stated objectives and predefined eligibility criteria, (b) an explicit reproducible methodology, (c) a systematic search, (d) an assessment of the validity of the findings of the included studies and (e) a systematic presentation, and synthesis, of the characteristics and findings of the included studies.22
CAM, complementary and alternative medicine; MDD, major depressive disorder; RCT, randomised controlled trial.