Influence of initial severity of depression on effectiveness of low intensity interventions: meta-analysis of individual patient data
| Autor: | Alex J. Sutton, Filip Smit, Sarah Knowles, Michael Barkham, Annemieke van Straten, Tony Kendrick, Linda L. Bilich, Simon Gilbody, Lisanne Warmerdam, Marcus J.H. Huibers, Helen Christensen, Karina Lovell, Björn Meyer, Evangelos Kontopantelis, Emily T. Liu, Peter Bower, Pim Cuijpers, Gerhard Andersson, David Richards |
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| Přispěvatelé: | Clinical Psychology, EMGO+ - Mental Health, Epidemiology and Data Science, EMGO - Mental health |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Psychological intervention Social Sciences macromolecular substances Severity of Illness Index SDG 3 - Good Health and Well-being Severity of illness medicine Humans Psychology Psychiatry Depression (differential diagnoses) Medicine(all) Psychiatric Status Rating Scales Depressive Disorder business.industry Research Health sciences Samhällsvetenskap General Medicine Patient data Middle Aged United Kingdom Intensity (physics) Psychotherapy Meta-analysis Psychiatric status rating scales Physical therapy Female business |
| Zdroj: | Bower, P, Kontopantelis, E, Sutton, A, Kendrick, T, Richards, D, Gilbody, S, Knowles, S, Cuijpers, P, Andersson, G, Christensen, H M, Meyer, B, Huibers, M, Smit, F, Van Straten, A, Warmerdam, L, Barkham, M, Bilich, L, Lovell, K & Liu, E T-H 2013, ' Influence of initial severity of depression on effectiveness of low intensity interventions : meta-analysis of individual patient data ' BMJ, vol 346, no. February, f540 . DOI: 10.1136/bmj.f540 The BMJ Bower, P, Kontopantelis, E, Sutton, A, Kendrick, T, Richards, D A, Gilbody, S, Knowles, S, Cuijpers, P, Andersson, G, Christensen, H, Meyer, B, Huibers, M, Smit, F, Van Straten, A, Warmerdam, L, Barkham, M, Bilich, L, Lovell, K & Liu, E T H 2013, ' Influence of initial severity of depression on effectiveness of low intensity interventions: Meta-analysis of individual patient data ', Bmj, vol. 346, no. 7899, f540 . https://doi.org/10.1136/bmj.f540 British Medical Journal, 2013(346):f540, 1-11. BMJ Publishing Group Bower, P, kontopantelis, E, Sutton, A, Kendrick, T, Richards, D A, Gilbody, S, Knowles, S, Cuijpers, P, Andersson, G, Christensen, H, Meyer, B, Huibers, M J H, Smit, H F E, van Straten, A, Warmerdam, E H, Barkham, M, Bilich, L, Lovell, K & Tung-Hsueh Liu, E 2013, ' Influence of initial severity of depression on effectiveness of low intensity interventions: meta-analysis of individual patient data ', British Medical Journal, vol. 2013, no. 346, f540, pp. 1-11 . https://doi.org/10.1136/bmj.f540 British Medical Journal, 2013(346):f540, 1-11 Bower, P, Kontopantelis, E, Sutton, A, Kendrick, T, Richards, D, Gilbody, S, Knowles, S, Cuijpers, P, Andersson, G, Christensen, H M, Meyer, B, Huibers, M, Smit, F, Van Straten, A, Warmerdam, L, Barkham, M, Bilich, L, Lovell, K & Liu, E T-H 2013, ' Influence of initial severity of depression on effectiveness of low intensity interventions : meta-analysis of individual patient data ', BMJ, vol. 346, no. 7899, f540 . https://doi.org/10.1136/bmj.f540 |
| ISSN: | 0959-535X |
| DOI: | 10.1136/bmj.f540 |
| Popis: | Objective To assess how initial severity of depression affects the benefit derived from low intensity interventions for depression. Design Meta-analysis of individual patient data from 16 datasets comparing low intensity interventions with usual care. Setting Primary care and community settings. Participants 2470 patients with depression. Interventions Low intensity interventions for depression (such as guided self help by means of written materials and limited professional support, and internet delivered interventions). Main outcome measures Depression outcomes (measured with the Beck Depression Inventory or Center for Epidemiologic Studies Depression Scale), and the effect of initial depression severity on the effects of low intensity interventions. Results Although patients were referred for low intensity interventions, many had moderate to severe depression at baseline. We found a significant interaction between baseline severity and treatment effect (coefficient −0.1 (95% CI −0.19 to −0.002)), suggesting that patients who are more severely depressed at baseline demonstrate larger treatment effects than those who are less severely depressed. However, the magnitude of the interaction (equivalent to an additional drop of around one point on the Beck Depression Inventory for a one standard deviation increase in initial severity) was small and may not be clinically significant. Conclusions The data suggest that patients with more severe depression at baseline show at least as much clinical benefit from low intensity interventions as less severely depressed patients and could usefully be offered these interventions as part of a stepped care model. Funding Agencies|UK National Institute of Health Research (NIHR) School for Primary Care Research |
| Databáze: | OpenAIRE |
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