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[St. John's wort for depression--development of a Cochrane review from 1993 to 1996]

Klaus Linde1

  • 1Zentrum für naturheilkundliche Forschung, II. Medizinische Klinik und Poliklinik, Technische Universität München. Klaus.Linde@lrz.tum.de

Zeitschrift Fur Evidenz, Fortbildung Und Qualitat Im Gesundheitswesen
|February 17, 2009
PubMed

Insights

The Cochrane review on St. John's wort (Hypericum perforatum L.) for depression has evolved since 1993. Despite methodological improvements and more trials, interpreting current evidence is challenging.

Area of Science:

  • Integrative Medicine
  • Evidence-Based Medicine
  • Psychiatry

Context:

  • The Cochrane Collaboration, a global independent network, facilitates evidence-based healthcare decisions.
  • The Cochrane Review Group for Depression, Anxiety and Neuroses (CCDAN) was established to systematically evaluate treatments.
  • St. John's wort (Hypericum perforatum L.) has been a focus for depression treatment research.

Purpose:

  • To chronicle the historical development and evolution of the Cochrane review on St. John's wort for depression.
  • To document changes in review methodology, trial inclusion, and interpretation of evidence over time.

Summary:

  • The Cochrane review on St. John's wort for depression began in 1993, with its first print version in 1996 (23 trials) and the first Cochrane version in 1998 (27 trials).
  • Subsequent updates in 2005 (37 trials) and 2008 (29 trials) required similar resources to the initial review due to evolving criteria and methods.
  • A significant turnover of included trials occurred, with only one trial from 1996 remaining in the 2008 version.

Impact:

  • The historical trajectory illustrates the dynamic nature of systematic reviews and evidence synthesis.
  • Despite advancements and a larger trial base, the interpretability of current evidence on St. John's wort for depression has decreased compared to earlier versions.
  • This historical account provides valuable insights into the challenges and complexities of maintaining and updating systematic reviews in mental health.

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