Is social support pre-treatment associated with prognosis for adults with depression in primary care?
depression
individual patient data meta-analysis
prognosis
social support
treatment outcome
Journal
Acta psychiatrica Scandinavica
ISSN: 1600-0447
Titre abrégé: Acta Psychiatr Scand
Pays: United States
ID NLM: 0370364
Informations de publication
Date de publication:
05 2021
05 2021
Historique:
revised:
14
12
2020
received:
21
10
2020
accepted:
01
02
2021
pubmed:
7
2
2021
medline:
19
8
2021
entrez:
6
2
2021
Statut:
ppublish
Résumé
Depressed patients rate social support as important for prognosis, but evidence for a prognostic effect is lacking. We aimed to test the association between social support and prognosis independent of treatment type, and the severity of depression, and other clinical features indicating a more severe illness. Individual patient data were collated from all six eligible RCTs (n = 2858) of adults seeking treatment for depression in primary care. Participants were randomized to any treatment and completed the same baseline assessment of social support and clinical severity factors. Two-stage random effects meta-analyses were conducted. Social support was associated with prognosis independent of randomized treatment but effects were smaller when adjusting for depressive symptoms and durations of depression and anxiety, history of antidepressant treatment, and comorbid panic disorder: percentage decrease in depressive symptoms at 3-4 months per z-score increase in social support = -4.14(95%CI: -6.91 to -1.29). Those with a severe lack of social support had considerably worse prognoses than those with no lack of social support: increase in depressive symptoms at 3-4 months = 14.64%(4.25% to 26.06%). Overall, large differences in social support pre-treatment were associated with differences in prognostic outcomes. Adding the Social Support scale to clinical assessments may be informative, but after adjusting for routinely assessed clinical prognostic factors the differences in prognosis are unlikely to be of a clinically important magnitude. Future studies might investigate more intensive treatments and more regular clinical reviews to mitigate risks of poor prognosis for those reporting a severe lack of social support.
Identifiants
pubmed: 33548056
doi: 10.1111/acps.13285
pmc: PMC7610633
mid: EMS116940
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
392-405Subventions
Organisme : Wellcome Trust
ID : 201292
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_12023/21
Pays : United Kingdom
Organisme : MQ: Transforming Mental Health
ID : MQDS16/72
Pays : United Kingdom
Organisme : Medical Research Council
ID : G0200243
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00004/06
Pays : United Kingdom
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 201292/Z/16/Z
Pays : United Kingdom
Informations de copyright
© 2021 The Authors. Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.
Références
Nat Rev Drug Discov. 2007 Apr;6(4):287-93
pubmed: 17380152
JAMA Intern Med. 2016 Oct 1;176(10):1482-1491
pubmed: 27571438
J Health Soc Behav. 2010;51 Suppl:S54-66
pubmed: 20943583
Psychol Med. 1992 May;22(2):465-86
pubmed: 1615114
J Behav Med. 2006 Aug;29(4):377-87
pubmed: 16758315
Int J Methods Psychiatr Res. 2014 Jan;23 Suppl 1:1-14
pubmed: 24375532
PLoS One. 2013 Apr 30;8(4):e62396
pubmed: 23646128
Clin Psychol Rev. 2018 Aug;64:13-38
pubmed: 30075313
BMC Med Res Methodol. 2008 Oct 30;8:70
pubmed: 18973665
Curr Opin Psychiatry. 2018 Jan;31(1):32-39
pubmed: 29076894
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120
World Psychiatry. 2017 Feb;16(1):30-40
pubmed: 28127922
Psychol Med. 2015 Nov;45(15):3269-79
pubmed: 26165748
J Psychosom Res. 1967 Aug;11(2):213-8
pubmed: 6059863
J Clin Epidemiol. 2006 Jul;59(7):697-703
pubmed: 16765272
Lancet. 2013 Feb 2;381(9864):375-84
pubmed: 23219570
BMJ Open. 2016 Nov 16;6(11):e012337
pubmed: 27852712
J Health Soc Behav. 2011 Jun;52(2):145-61
pubmed: 21673143
BMC Psychiatry. 2018 May 29;18(1):156
pubmed: 29843662
J Affect Disord. 2018 May;232:316-328
pubmed: 29501991
Am J Psychiatry. 2020 Oct 1;177(10):944-954
pubmed: 32791893
J Ment Health. 2015 Dec;24(6):342-6
pubmed: 25643091
Br J Psychiatry. 2016 Oct;209(4):284-293
pubmed: 27445355
World Psychiatry. 2018 Jun;17(2):121-122
pubmed: 29856539
BMJ. 2008 Apr 26;336(7650):924-6
pubmed: 18436948
Br J Psychiatry. 2012 Feb;200(2):130-6
pubmed: 22194183
World Psychiatry. 2020 Feb;19(1):92-107
pubmed: 31922679
Psychol Med. 2005 May;35(5):705-14
pubmed: 15918347
Lancet Psychiatry. 2019 Nov;6(11):903-914
pubmed: 31543474
Psychol Rev. 2005 Apr;112(2):417-45
pubmed: 15783292
BMJ. 2012 Jun 06;344:e2758
pubmed: 22674921
BMJ. 2018 Oct 31;363:k4218
pubmed: 30381374
Neurosci Biobehav Rev. 2019 Jun;101:32-44
pubmed: 30922979
J Affect Disord. 2014 Jan;152-154:65-75
pubmed: 24210624
Br J Psychiatry. 2017 Feb;210(2):119-124
pubmed: 27908899
Lancet. 2009 Aug 22;374(9690):628-34
pubmed: 19700005
World Psychiatry. 2014 Oct;13(3):275-87
pubmed: 25273301
PLoS One. 2020 May 29;15(5):e0233535
pubmed: 32469922
Depress Anxiety. 2012 Apr;29(4):340-54
pubmed: 22511365
Ann Intern Med. 2013 Feb 19;158(4):280-6
pubmed: 23420236
BMJ. 1997 Feb 8;314(7078):420-4
pubmed: 9040389
Br J Psychiatry. 2019 Apr;214(4):225-229
pubmed: 30560742
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
World Psychiatry. 2013 Jun;12(2):165-70
pubmed: 23737426
Wellcome Open Res. 2019 Apr 16;4:69
pubmed: 31815189