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Cochrane Database of Systematic Reviews

Drugs versus placebo for dysthymia

Overview of attention for article published in Cochrane database of systematic reviews, June 2015
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40 Mendeley
Drugs versus placebo for dysthymia
Published in
Cochrane database of systematic reviews, June 2015
DOI 10.1002/14651858.cd001130.pub2
Pubmed ID

Mauricio Silva de Lima, Joanna Moncrieff, Bernardo GO Soares


Dysthymia is a depressive disorder of chronic nature but of lower severity than major depression. Depressive symptoms are more or less continuous for at least two years. Patients with this disorder experience considerable social dysfunction and disability and are more likely than the general population to use general medical services and to take non-specific psychotropic drugs. Examining the use of pharmacotherapy for this condition is of critical importance. The aim of this review was to conduct a systematic review of all randomised controlled trials comparing drugs and placebo for the treatment of dysthymia. Electronic searches of The Cochrane Library, MEDLINE, EMBASE, PsycLIT, biological abstracts and LILACS; reference searching; personal communication; conference abstracts; unpublished trials from the pharmaceutical industry; book chapters on the treatment of depression. All randomised controlled trials that focused on the use of drugs versus placebo for dysthymic patients were included.Exclusion criteria were: non-randomised controlled trials, a mixture of major depression and dysthymia (trials not providing separate data) and depression secondary to other disorders (e.g. substance abuse). The reviewers extracted the data independently. In order to achieve an intention-to-treat analysis it was assumed, when not reported in the trial, that people who died or dropped out had no improvement. Authors of relevant trials were contacted for additional and missing data. Absence of treatment response as defined by authors was the main measure of outcome used. Relative risks and 95% confidence intervals (CI) of dichotomous data were calculated with the random-effects model. Where possible, number needed to treat and number needed to harm were estimated, taking the reciprocal of the absolute risk reduction. Currently the review includes 29 trials, 17 reporting data for the main outcome measures. Similar results were obtained in terms of efficacy for different groups of drugs, such as tricyclic antidepressants, selective serotonin reuptake inhibitors, monoamine oxidase inhibitors and other drugs (sulpiride, amineptine, and ritanserin). The pooled relative risk for absence of treatment response was 0.68 (95% CI 0.59 to 0.78) for tricyclic antidepressants and the number needed to treat was 4.3 (95% CI 3.2 to 6.5). Selective serotonin reuptake inhibitors showed similar relative risk for this outcome: 0.68 (95% CI 0.56 to 0.82), the number needed to treat was 5 (95% CI 3.3 to 9). Concerning monoamine oxidase inhibitors, the relative risk was 0.59 (95% CI 0.48 to 0.71) and the number needed to treat was 2.9 (95% CI 2.2 to 4.3). Other drugs (amisulpiride, amineptine and ritanserin) showed similar results in terms of absence of treatment response. Using more stringent criteria for improvement, i.e. full remission, the results were unchanged. Patients treated on tricyclic antidepressants were more likely to report adverse events, compared with placebo. Drugs are effective in the treatment of dysthymia with no differences between and within drug classes. Tricyclic antidepressants are more likely to cause adverse events and dropouts. As dysthymia is a chronic condition, there remains little information on quality of life and medium or long-term outcome.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 40 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 40 100%

Demographic breakdown

Readers by professional status Count As %
Student > Doctoral Student 10 25%
Professor > Associate Professor 5 13%
Researcher 4 10%
Student > Master 3 8%
Student > Bachelor 3 8%
Other 9 23%
Unknown 6 15%
Readers by discipline Count As %
Medicine and Dentistry 20 50%
Psychology 4 10%
Nursing and Health Professions 2 5%
Linguistics 2 5%
Pharmacology, Toxicology and Pharmaceutical Science 2 5%
Other 4 10%
Unknown 6 15%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 March 2020.
All research outputs
of 17,175,498 outputs
Outputs from Cochrane database of systematic reviews
of 11,634 outputs
Outputs of similar age
of 237,759 outputs
Outputs of similar age from Cochrane database of systematic reviews
of 255 outputs
Altmetric has tracked 17,175,498 research outputs across all sources so far. This one is in the 23rd percentile – i.e., 23% of other outputs scored the same or lower than it.
So far Altmetric has tracked 11,634 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 24.7. This one is in the 9th percentile – i.e., 9% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 237,759 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 35th percentile – i.e., 35% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 255 others from the same source and published within six weeks on either side of this one. This one is in the 8th percentile – i.e., 8% of its contemporaries scored the same or lower than it.