Treatment of major depressive disorder (MDD) or dysthymic disorder (DD) in spinal cord injury (SCI) patients: a protocol for a systematic review and network meta-analysis

BMJ Open, 2022 · DOI: 10.1136/bmjopen-2021-055800 · Published: January 1, 2022

Spinal Cord Injury Mental Health Research Methodology & Design

Simple Explanation

This study addresses the lack of clarity regarding the best treatments for depression in individuals with spinal cord injuries (SCI). It aims to systematically review and compare the effectiveness and side effects of various treatments, both pharmacological and non-pharmacological. The researchers will search multiple databases and clinical trial registries to gather relevant studies. They will then analyze the data using a Bayesian network meta-analysis to compare different treatments. The ultimate goal is to provide strong evidence to guide treatment decisions for depression in SCI patients, helping policymakers and clinicians make informed choices.

Study Duration

Not specified

Participants

Adult patients (≥18 years old) with SCI and MDD or DD

Evidence Level

Systematic review and network meta-analysis protocol

Key Findings

1
The study aims to compare the therapeutic and adverse effects of pharmacological and non-pharmacological treatments for MDD or DD in patients with SCI.
2
The primary outcome will be the severity of depressive symptoms, while secondary outcomes include anxiety, pain, sleep disorder, SCI-related disability, social participation, quality of life, adverse effects, adherence, and tolerability.
3
A network meta-analysis will be performed to compare the effects of various treatments, even those not directly compared in individual studies.

Research Summary

This study protocol outlines a systematic review and network meta-analysis to evaluate treatments for major depressive disorder (MDD) or dysthymic disorder (DD) in patients with spinal cord injury (SCI). The review will include randomized and non-randomized controlled trials, examining both pharmacological and non-pharmacological interventions. The primary outcome is the severity of depressive symptoms. The results will be disseminated through peer-reviewed publications and conference presentations, aiming to inform clinical practice and policy-making for managing depression in SCI patients.

Practical Implications

Informed Treatment Decisions

The study will provide evidence-based guidance for clinicians in selecting the most effective treatments for depression in SCI patients.

Policy Development

The findings can assist policymakers in developing guidelines and allocating resources for mental health care in SCI populations.

Improved Patient Outcomes

By identifying optimal treatment strategies, the study aims to improve the mental health and overall well-being of individuals with SCI and depression.

Study Limitations

1
The heterogeneity and level of evidence of the various studies may affect the implications of our study.
2
It may not be possible to combine both randomised controlled trials and non-randomised controlled trials in a single network meta-analysis.
3
This is a protocol; the actual review may encounter unforeseen limitations during the data extraction and analysis phases.

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