Fig. 1

Study population selection. From the 2010-2019 MEPS data, we identified 17,040 patients diagnosed with depression at round 1 or 2, of which 10,215 patients used SSRI/SNRI at round 1 or 2. Each panel in MEPS data includes 5 rounds within 2 years. The reason for limiting to the first two rounds was to allow at least one year follow-up time for each patient. We excluded patients combining SSRI/SNRI with psychotherapy at any round (n=2.842), aged <50 years at round 1 (n=4106), missed cognitive impairment data at any round (n=29), and diagnosed with dementia before the index round (n=528). There were 2,710 patients included in out analytical cohort, with 2,402 (89%) using SSRIs/SNRIs and 308 (11%) receiving psychotherapy.