Concentrated transdiagnostic and cross-disciplinary group treatment for patients with depression and with anxiety: a pilot study.


Journal

BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559

Informations de publication

Date de publication:
05 09 2022
Historique:
received: 10 02 2022
accepted: 24 08 2022
entrez: 4 9 2022
pubmed: 5 9 2022
medline: 9 9 2022
Statut: epublish

Résumé

A number of treatment approaches have shown efficacy for depression and/or anxiety, yet there is a paucity of research on potentially cost-effective concentrated approaches. Based on our previous experience with concentrated treatment in disorders such as Obsessive-Compulsive Disorder and chronic fatigue, we proposed that this novel approach could be useful for other conditions, including depression and/or anxiety. As a pre-requisite for a future randomized controlled trial, the aim of this study was to investigate the acceptability, satisfaction and effectiveness of a transdiagnostic, interdisciplinary group treatment delivered during 5 consecutive days to groups of 6-10 patients with depression and/or anxiety. This was a non-randomized clinical intervention pilot study in line with a published protocol. Forty-two consecutively referred patients, aged 19-47 (mean age 31.7, SD = 8.12) were included and completed treatment. All had a severity of their problems that entitled them to care in the specialist public mental health care. Self-reported age when the symptoms became a problem was 20.9 years. Mean number of prior treatment courses was 2.77 (SD = 2.19; range 0-8). Acceptability was defined as the proportion of eligible patients who accepted and completed the treatment. Satisfaction was evaluated by Client Satisfaction Questionnaire-8. Secondary objectives were to assess the treatment effectiveness by questionnaires at pre-treatment, seven days post-treatment and three months follow-up. The treatment was highly acceptable (91.3% accepted, all completed), and patients were highly satisfied with the treatment, including the amount. Functional impairment, as measured by Work and Social Adjustment Scale (WSAS) improved significantly (p < .0005) from "severe" (mean 25.4 SD = 6.59) to "less severe" (mean 13.37, SD = 9.43) at 3 months follow-up. Using the Generalized Anxiety Disorder Scale (GAD-7) and the Patient Health Questionnaire (PHQ-9), the effect sizes at 3 months follow-up were 1.21 for anxiety and 1.3 for depression. More than 80% reported reduced utilization of mental health care, and 67% had not used, or had used the family doctor less, for anxiety or depression. 52% had not used, or had reduced, medication for their disorder. The concentrated, interdisciplinary treatment approach yielded promising results. Long-term follow up is warranted. This study is registered in Clinical Trials, identifier NCT05234281 and approval date 09/02/2022.

Sections du résumé

BACKGROUND
A number of treatment approaches have shown efficacy for depression and/or anxiety, yet there is a paucity of research on potentially cost-effective concentrated approaches. Based on our previous experience with concentrated treatment in disorders such as Obsessive-Compulsive Disorder and chronic fatigue, we proposed that this novel approach could be useful for other conditions, including depression and/or anxiety. As a pre-requisite for a future randomized controlled trial, the aim of this study was to investigate the acceptability, satisfaction and effectiveness of a transdiagnostic, interdisciplinary group treatment delivered during 5 consecutive days to groups of 6-10 patients with depression and/or anxiety.
METHODS
This was a non-randomized clinical intervention pilot study in line with a published protocol. Forty-two consecutively referred patients, aged 19-47 (mean age 31.7, SD = 8.12) were included and completed treatment. All had a severity of their problems that entitled them to care in the specialist public mental health care. Self-reported age when the symptoms became a problem was 20.9 years. Mean number of prior treatment courses was 2.77 (SD = 2.19; range 0-8). Acceptability was defined as the proportion of eligible patients who accepted and completed the treatment. Satisfaction was evaluated by Client Satisfaction Questionnaire-8. Secondary objectives were to assess the treatment effectiveness by questionnaires at pre-treatment, seven days post-treatment and three months follow-up.
RESULTS
The treatment was highly acceptable (91.3% accepted, all completed), and patients were highly satisfied with the treatment, including the amount. Functional impairment, as measured by Work and Social Adjustment Scale (WSAS) improved significantly (p < .0005) from "severe" (mean 25.4 SD = 6.59) to "less severe" (mean 13.37, SD = 9.43) at 3 months follow-up. Using the Generalized Anxiety Disorder Scale (GAD-7) and the Patient Health Questionnaire (PHQ-9), the effect sizes at 3 months follow-up were 1.21 for anxiety and 1.3 for depression. More than 80% reported reduced utilization of mental health care, and 67% had not used, or had used the family doctor less, for anxiety or depression. 52% had not used, or had reduced, medication for their disorder.
CONCLUSIONS
The concentrated, interdisciplinary treatment approach yielded promising results. Long-term follow up is warranted.
TRIAL REGISTRATION
This study is registered in Clinical Trials, identifier NCT05234281 and approval date 09/02/2022.

Identifiants

pubmed: 36058925
doi: 10.1186/s12888-022-04229-y
pii: 10.1186/s12888-022-04229-y
pmc: PMC9441319
doi:

Banques de données

ClinicalTrials.gov
['NCT05234281']

Types de publication

Clinical Trial Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

587

Informations de copyright

© 2022. The Author(s).

Références

Arch Intern Med. 2006 May 22;166(10):1092-7
pubmed: 16717171
J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57
pubmed: 9881538
J Affect Disord. 2016 Jul 15;199:30-41
pubmed: 27060430
Cogn Behav Ther. 2014;43(3):171-84
pubmed: 24646219
Lancet. 2018 Feb 17;391(10121):679-686
pubmed: 29224931
J Anxiety Disord. 2017 Mar;46:11-24
pubmed: 27466074
J Psychosom Res. 2011 Sep;71(3):124-8
pubmed: 21843745
Cogn Behav Ther. 2019 Mar;48(2):89-105
pubmed: 30088441
JAMA. 2020 Jun 9;323(22):2290-2300
pubmed: 32515813
BMC Psychiatry. 2018 Aug 16;18(1):260
pubmed: 30115041
BMC Psychiatry. 2018 Oct 4;18(1):323
pubmed: 30286745
Front Psychol. 2013 Nov 26;4:863
pubmed: 24324449
Front Psychiatry. 2018 Dec 20;9:720
pubmed: 30618889
JMIR Res Protoc. 2021 Oct 7;10(10):e32216
pubmed: 34505838
Lancet. 2013 Nov 9;382(9904):1575-86
pubmed: 23993280
J Ment Health. 2014 Feb;23(1):38-45
pubmed: 24484191
Br J Psychiatry. 2002 May;180:461-4
pubmed: 11983645
J Behav Ther Exp Psychiatry. 2008 Sep;39(3):381-90
pubmed: 18005932
Psychol Health. 2015;30(11):1361-85
pubmed: 26181764
J Consult Clin Psychol. 1991 Feb;59(1):12-9
pubmed: 2002127
Br J Clin Psychol. 2021 Mar;60(1):1-37
pubmed: 32578231
Eur Psychiatry. 2010 Apr;25(3):172-7
pubmed: 19553089
Clin Psychol Rev. 2007 Apr;27(3):318-26
pubmed: 17184887
Front Psychol. 2018 Jun 26;9:1044
pubmed: 29997546
J Psychosom Res. 2006 Jun;60(6):631-7
pubmed: 16731240
Psychiatr Clin North Am. 2017 Dec;40(4):751-770
pubmed: 29080598
Front Psychol. 2019 Nov 15;10:2500
pubmed: 31803089
J Behav Ther Exp Psychiatry. 2006 Sep;37(3):206-12
pubmed: 16125666
Eval Program Plann. 1979;2(3):197-207
pubmed: 10245370
Nord J Psychiatry. 2015 Feb;69(2):126-31
pubmed: 25124119
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
PLoS One. 2012;7(8):e42567
pubmed: 22905150

Auteurs

Gerd Kvale (G)

Haukeland University Hospital, Bergen Division of Mental Health, 5021, Bergen, Norway. gerd.kvale@helse-bergen.no.
Department of Clinical Psychology, University of Bergen, Bergen, Norway. gerd.kvale@helse-bergen.no.

Ane Wilhelmsen-Langeland (A)

Haukeland University Hospital, Bergen Division of Mental Health, 5021, Bergen, Norway.
Helse i Hardanger, Øystese, Norway.

Marte Jürgensen (M)

Haukeland University Hospital, Bergen Division of Mental Health, 5021, Bergen, Norway.
Helse i Hardanger, Øystese, Norway.

Sigurd William Hystad (SW)

Department of Psychosocial Science, University of Bergen, Bergen, Norway.

Lars-Göran Öst (LG)

Department of Psychology, Stockholm University, Stockholm, Sweden.

Eirik Søfteland (E)

Helse i Hardanger, Øystese, Norway.
Department of Medicine, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Science, University of Bergen, Norway, Norway.

Tore Børtveit (T)

Haukeland University Hospital, Bergen Division of Mental Health, 5021, Bergen, Norway.
Helse i Hardanger, Øystese, Norway.
Division of Mental Health and Addiction, Vestfold Hospital, Vestfold, Norway.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH