关键词：临床治疗;抑郁;搜索策略;患者;治疗反应;数据提取
摘 要：Depression is a complex mental illness associated with disability and reduced quality of life for the person with depression, as well as substantial societal burden. Major depressive disorder (MDD) is the second leading medical cause of long-term disability, the fourth leading cause of global burden of disease, and is predicted to become the second highest cause of disability by 2020. Depression exerts a negative impact on physical health; it reduces adherence to medical treatment, reduces participation in preventive activities, and increases the likelihood of risk factors such as obesity, smoking, and sedentary lifestyles. MDD may be associated with immune dysfunction and cardiovascular disease, endocrine and neurological diseases, and a general increase in chronic disease incidence. The primary goal of this comparative effectiveness review is to examine the evidence guiding clinical treatment decisions and ultimately to aid clinicians in their care of patients when selective serotonin reuptake inhibitors (SSRIs) therapy for an index episode does not result in an adequate treatment response.