Concentrated transdiagnostic and cross-disciplinary group treatment for patients with depression and with anxiety: a pilot study.
Anxiety
Concentrated
Depression
Group treatment
Interdisciplinary
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
05 09 2022
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
587Informations 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