{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:50:38Z","timestamp":1791273038058,"version":"4.1.0"},"reference-count":34,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"unspecified","delay-in-days":278,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000092","name":"U.S. National Library of Medicine","doi-asserted-by":"publisher","award":["T15LM007092"],"award-info":[{"award-number":["T15LM007092"]}],"id":[{"id":"10.13039\/100000092","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0033291726106321_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>When deciding on antidepressant maintenance with clinicians, remitted patients must weigh the burdens of continued use against the benefit of less time depressed. This benefit is often inferred qualitatively from relapse-frequency data, even though expected time depressed also depends on episode duration, antidepressant re-initiation, and how evidence from highly recurrent populations applies to patients with fewer prior episodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726106321_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We developed a health-state transition model to combine evidence on recurrence, episode duration, re-initiation, and treatment effects into expected time depressed and time taking antidepressants under maintenance versus active monitoring. Adults in remission were simulated for 5\u00a0years across groups based on depression history. We summarized the trade-off as additional antidepressant use\n                      <jats:italic>required<\/jats:italic>\n                      to avert 1\u00a0month of depression. The decision framework links this estimate to patient preferences by comparing\n                      <jats:italic>required<\/jats:italic>\n                      with\n                      <jats:italic>acceptable<\/jats:italic>\n                      use, allowing patients who expect greater consequences of relapse or experience fewer treatment burdens to consider more antidepressant use acceptable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726106321_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Maintenance efficiency varied substantially with recurrence history. Each month of depression averted required 1.5 additional years of antidepressant use among patients with 4\u20135 prior episodes; 2.8\u00a0years with 2\u20133 prior episodes, 5.1\u00a0years after one moderate-to-severe episode, and 11.8\u00a0years after one mild episode. When these trade-offs are acceptable, patients are modeled to prefer maintenance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291726106321_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The model expresses the maintenance trade-off as a ratio of benefits and burdens. Preferences and clinical judgment determine for whom the ratio is acceptable. Empirical work can determine whether this improves maintenance decisions in practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291726106321","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:52:20Z","timestamp":1791269540000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Antidepressant maintenance versus active monitoring after depression remission: a decision analysis and framework linking recurrence probability and patient preferences"],"prefix":"10.1017","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1757-1451","authenticated-orcid":false,"given":"William U.","family":"Meyerson","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/002pd6e78","id-type":"ROR","asserted-by":"publisher"}],"name":"Massachusetts General Hospital"},{"id":[{"id":"https:\/\/ror.org\/04c524341","id-type":"ROR","asserted-by":"publisher"}],"name":"Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5379-2502","authenticated-orcid":false,"given":"Tianxi","family":"Cai","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03vek6s52","id-type":"ROR","asserted-by":"publisher"}],"name":"Harvard University T H Chan"},{"id":[{"id":"https:\/\/ror.org\/03vek6s52","id-type":"ROR","asserted-by":"publisher"}],"name":"Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0381-6334","authenticated-orcid":false,"given":"Jordan W.","family":"Smoller","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04c524341","id-type":"ROR","asserted-by":"publisher"}],"name":"Harvard Medical School"},{"id":[{"id":"https:\/\/ror.org\/002pd6e78","id-type":"ROR","asserted-by":"publisher"}],"name":"Massachusetts General Hospital"},{"id":[{"id":"https:\/\/ror.org\/05a0ya142","id-type":"ROR","asserted-by":"publisher"}],"name":"Broad Institute of MIT and Harvard"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"S0033291726106321_r7","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.2044"},{"key":"S0033291726106321_r31","first-page":"CD001431","article-title":"Decision aids for people facing health treatment or screening decisions","author":"Stacey","year":"2024","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"S0033291726106321_r5","volume-title":"Practice guideline for the treatment of patients with major depressive disorder","author":"Gelenberg","year":"2010"},{"key":"S0033291726106321_r32","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(25)00330-X"},{"key":"S0033291726106321_r17","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-020-0843-0"},{"key":"S0033291726106321_r2","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S110632"},{"key":"S0033291726106321_r15","doi-asserted-by":"publisher","DOI":"10.1177\/23814683211061097"},{"key":"S0033291726106321_r33","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291720001610"},{"key":"S0033291726106321_r16","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.55.8.694"},{"key":"S0033291726106321_r28","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-013-0129-4"},{"key":"S0033291726106321_r6","doi-asserted-by":"publisher","DOI":"10.1017\/cts.2017.2"},{"key":"S0033291726106321_r10","doi-asserted-by":"publisher","DOI":"10.1177\/20451253211032051"},{"key":"S0033291726106321_r11","first-page":"17r11470","article-title":"Trajectories of acute antidepressant efficacy: How long to wait for response? A systematic review and meta-analysis of long-term, placebo-controlled acute treatment trials","volume":"79","author":"Henssler","year":"2018","journal-title":"The Journal of Clinical Psychiatry"},{"key":"S0033291726106321_r29","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2008.01711.x"},{"key":"S0033291726106321_r25","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-072220-021440"},{"key":"S0033291726106321_r4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k1951"},{"key":"S0033291726106321_r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2005.06.005"},{"key":"S0033291726106321_r34","doi-asserted-by":"publisher","DOI":"10.1093\/haschl\/qxae110"},{"key":"S0033291726106321_r27","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-4733.2001.44053.x"},{"key":"S0033291726106321_r9","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2017.4602"},{"key":"S0033291726106321_r12","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2019.0633"},{"key":"S0033291726106321_r30","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.181.3.208"},{"key":"S0033291726106321_r13","doi-asserted-by":"publisher","DOI":"10.1192\/bja.2021.62"},{"key":"S0033291726106321_r18","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-022-01920-0"},{"key":"S0033291726106321_r19","doi-asserted-by":"publisher","DOI":"10.1177\/07067437241245384"},{"key":"S0033291726106321_r8","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780195108248.001.0001"},{"key":"S0033291726106321_r14","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2024.115926"},{"key":"S0033291726106321_r1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715002676"},{"key":"S0033291726106321_r20","doi-asserted-by":"publisher","DOI":"10.1080\/14737167.2021.1844566"},{"key":"S0033291726106321_r24","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291710002291"},{"key":"S0033291726106321_r23","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.25m15863"},{"key":"S0033291726106321_r22","doi-asserted-by":"publisher","DOI":"10.7326\/M22-1603"},{"key":"S0033291726106321_r26","unstructured":"National Institute for Health and Care Excellence. (2022). Depression in adults: Treatment and management (NICE Guideline No. NG222). Retrieved from https:\/\/www.nice.org.uk\/guidance\/ng222 20 July 2026."},{"key":"S0033291726106321_r21","doi-asserted-by":"publisher","DOI":"10.1017\/neu.2023.6"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0033291726106321","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:52:23Z","timestamp":1791269543000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0033291726106321\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":34,"alternative-id":["S0033291726106321"],"URL":"https:\/\/doi.org\/10.1017\/s0033291726106321","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e318"}}