ATLAS-1: Advanced Trial for Longitudinal Assessment in Salma 1

This observational study (n=5000) will examine adults with depressed mood who are receiving esketamine, conventional rTMS, or SAINT as part of routine care, with the aim of assessing the feasibility and clinical utility of predictive models of treatment response built from multimodal clinical data. It will use integrated real-world datasets to explore whether personalised tools could help guide treatment selection in depression. Participants must be 18 years or older, able to give informed consent, and prescribed one of the listed treatments in standard clinical practice. The main outcome is the Patient Health Questionnaire 9-item (PHQ-9), measured pre-treatment, post-treatment, 2 weeks after treatment, and then monthly for 12 months. Retrospective clinical and research data from existing databases may also be included, where available and authorised, to support model development and validation.