Adaptive and innovative trial designs in anxiety and mood disorders: a scoping review

Anxiety and mood disorders impose a substantial and growing global burden of disease. Traditional randomized controlled trials (RCTs) are limited by large sample size requirements, long study durations, high costs, and low efficiency, which hinder the development of effective interventions. While adaptive and innovative trial designs (e.g., sequential multiple assignment randomized trial designs, master protocol designs, and Bayesian designs) have well-documented theoretical advantages and successful applications, their current implementation status, benefits, and challenges in anxiety and mood disorder lack systematic synthesis. Conducting a scoping review of practical implementation cases of such designs can systematically collate the current research status, identify research gaps, and further advance the development of clinical trial methodologies for anxiety and mood disorders.