Are students less likely to respond to routinely delivered psychological treatment? A retrospective cohort analysis.

Young Adult Humans Adolescent Adult Retrospective Studies State Medicine Anxiety Disorders / therapy Students / psychology Cohort Studies
Anxiety Cohort Depression Mental health Psychological treatment Student

Journal

Comprehensive psychiatry
ISSN: 1532-8384
Titre abrégé: Compr Psychiatry
Pays: United States
ID NLM: 0372612

Informations de publication

Date de publication:
11 2022
Historique:
received: 05 04 2022
revised: 08 09 2022
accepted: 27 09 2022
pubmed: 4 10 2022
medline: 9 11 2022
entrez: 3 10 2022
Statut: ppublish

Résumé

Depression and anxiety disorders are increasingly prevalent among university students, making the provision of effective treatment in this population a priority. Whilst campus-based services provide some psychological treatments, many students are treated by routine adult psychological treatment services which have no focus or adaptations to treatment for student populations. We aimed to compare psychological treatment outcomes between university students and young adults (aged 18-25) in employment to explore whether routinely delivered psychological interventions are equally effective for these groups, or whether students report poorer outcomes. A retrospective cohort was formed of 19,707 patients treated by eight National Health Service (NHS) Improving Access to Psychological Therapies (IAPT) services in England. Associations between student status (compared to same-age employed adults) and psychological treatment outcomes were explored using logistic regression models. Models were adjusted for important treatment, clinical and demographic characteristics, and propensity score matching was used to explore the robustness of effects. Students and the employed comparison group were similar on baseline characteristics at assessment, but students were less likely to reliably recover (OR = 0.90 [95% CI = 0.83;0.96]) and reliably improve (OR = 0.91 [95% CI = 0.84;0.98]) by the end of treatment in fully adjusted models. Students and the employed group did not differ regarding the likelihood of deterioration (OR = 0.89 [95% CI = 0.78;1.02]) or treatment dropout (OR = 1.01 [95% CI = 0.93;1.11]). Students appear at risk of poorer outcomes compared to employed younger adults when treated in routine psychological treatment services. Students may require additional support and treatment adaptations that account for student-specific stressors as this might improve psychological treatment outcomes.

Sections du résumé

BACKGROUND
Depression and anxiety disorders are increasingly prevalent among university students, making the provision of effective treatment in this population a priority. Whilst campus-based services provide some psychological treatments, many students are treated by routine adult psychological treatment services which have no focus or adaptations to treatment for student populations. We aimed to compare psychological treatment outcomes between university students and young adults (aged 18-25) in employment to explore whether routinely delivered psychological interventions are equally effective for these groups, or whether students report poorer outcomes.
METHODS
A retrospective cohort was formed of 19,707 patients treated by eight National Health Service (NHS) Improving Access to Psychological Therapies (IAPT) services in England. Associations between student status (compared to same-age employed adults) and psychological treatment outcomes were explored using logistic regression models. Models were adjusted for important treatment, clinical and demographic characteristics, and propensity score matching was used to explore the robustness of effects.
RESULTS
Students and the employed comparison group were similar on baseline characteristics at assessment, but students were less likely to reliably recover (OR = 0.90 [95% CI = 0.83;0.96]) and reliably improve (OR = 0.91 [95% CI = 0.84;0.98]) by the end of treatment in fully adjusted models. Students and the employed group did not differ regarding the likelihood of deterioration (OR = 0.89 [95% CI = 0.78;1.02]) or treatment dropout (OR = 1.01 [95% CI = 0.93;1.11]).
CONCLUSIONS
Students appear at risk of poorer outcomes compared to employed younger adults when treated in routine psychological treatment services. Students may require additional support and treatment adaptations that account for student-specific stressors as this might improve psychological treatment outcomes.

Identifiants

DOI: 10.1016/j.comppsych.2022.152348 PMID: 36191389 PMC: PMC9760567
pubmed: 36191389
pii: S0010-440X(22)00054-2
doi: 10.1016/j.comppsych.2022.152348
pmc: PMC9760567
pii:
doi:

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

152348

Informations de copyright

Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest There are no conflicts of interest for any authors involved in the preparation of this review.

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Auteurs

Phoebe Barnett (P)

Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational, & Health Psychology, University College London, London, UK; National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK. Electronic address: Phoebe.barnett@ucl.ac.uk.

Rob Saunders (R)

Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational, & Health Psychology, University College London, London, UK.

Joshua E J Buckman (JEJ)

Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational, & Health Psychology, University College London, London, UK; iCope - Camden & Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK.

Ana Cardoso (A)

North East London NHS Foundation Trust (NELFT), London, UK.

Mirko Cirkovic (M)

Talk Changes: City & Hackney IAPT Service, Homerton University Hospital NHS Foundation Trust, London, UK.

Judy Leibowitz (J)

iCope - Camden & Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK.

Nicole Main (N)

Let's Talk IAPT-Barnet, Enfield & Haringey Psychological Therapies Service, Barnet, Enfield & Haringey Mental Health Trust, London, UK.

Syed A Naqvi (SA)

North East London NHS Foundation Trust (NELFT), London, UK.

Satwant Singh (S)

Waltham Forest Talking Therapies-North East London Foundation Trust, Thorne House, London E11 4HU, UK.

Joshua Stott (J)

Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational, & Health Psychology, University College London, London, UK; Ageing, Dementia And Psychological Therapies (ADAPT) Lab, Research department of Clinical, Educational, & Health Psychology, University College London, UK.

Lila Varsani (L)

Let's Talk IAPT-Barnet, Enfield & Haringey Psychological Therapies Service, Barnet, Enfield & Haringey Mental Health Trust, London, UK.

Jon Wheatly (J)

Talk Changes: City & Hackney IAPT Service, Homerton University Hospital NHS Foundation Trust, London, UK.

Stephen Pilling (S)

Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational, & Health Psychology, University College London, London, UK; National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK; Camden and Islington NHS Foundation Trust, London, UK.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Jeune adulte › Are students less likely to respond to...
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questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Are students less likely to respond to...
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questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Are students less likely to respond to...
questionsmedicales.fr › Organisations et économie des soins de santé › Médecine d'État › Are students less likely to respond to...
questionsmedicales.fr › Troubles mentaux › Troubles anxieux › Are students less likely to respond to...
questionsmedicales.fr › Personnes › Étudiants › Are students less likely to respond to...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Are students less likely to respond to...