Antidepressants work. Period.

It's official: Antidepressants are not snake oil or a conspiracy--they work.

As you can see, these journalists (or their editors) attached extremely strong
titles to their science articles! An actual scientist wouldn't describe the results
of a study with such strong terms as "prove" or "They work." That's because
research in science is a steady accumulation of evidence--each study teaches us a
little bit more, but no study can "prove" a theory or a claim.

Not all headlines claimed proof; this one is more neutral:

Do antidepressants work?

The "study" mentioned in the three headlines above was actually a meta-analysis of
522 clinical trials (that is, randomized controlled studies) of antidepressants.
Here's a summary and interpretation according to the Neuroskeptic blog:

...the authors, Andrea Cipriani et al., conducted a meta-analysis of 522 clinical

trials looking at 21 antidepressants in adults. They conclude that �all
antidepressants were more effective than placebo�, but the benefits compared to
placebo were �mostly modest�. Using the Standardized Mean Difference (SMD) measure
of effect size, Cipriani et al. found an effect of 0.30, on a scale where 0.2 is
considered �small� and 0.5 �medium�.

a) Review: What does a meta-analysis do? Why might we value a meta-analysis over a
single study?

b) When the journalist describes the Standardized Mean Difference (SMD), they are
referring to a statistic very much like Cohen's d. As you can see, the conventions
for SMD are the same as for Cohen's d. Do you agree that the effect size of .31
could be considered "modest" according to these conventions?

c) I wrote above that "no study can 'prove' a theory or a claim." But what about a
meta-analysis--do you think meta-analyses are more likely to be able to prove a
theory? Are they definitive? (Why or why not?).

The Neuroskeptic criticized the media's coverage of this meta-analysis on a couple

of grounds. First, they pointed out how the results of the new study are almost
exactly the same as several old studies, suggesting that the new study is not
particularly groundbreaking:

The thing is, �effective but only modestly� has been the established view on
antidepressants for at least 10 years. Just to mention one prior study, the Turner
et al. (2008) meta-analysis found the overall effect size of antidepressants to be
a modest SMD=0.31 � almost exactly the same as the new estimate.

Second, the Neuroskeptic cleverly points out that, a few years ago, the media
assigned the opposite headline to virtually the same result:

Cipriani et al.�s estimate of the benefit of antidepressants is also very similar

to the estimate found in the notorious Kirsch et al. (2008) �antidepressants don�t
work� paper! Almost exactly a decade ago, Irving Kirsch et al. found the effect of
antidepressants over placebo to be SMD=0.32, a finding which was, inaccurately,
greeted by headlines such as �Anti-depressants �no better than dummy pills��.