Anao Zhang1, Cynthia Franklin2, Shijie Jing3, Lindsay A Bornheimer4, Audrey Hang Hai2, Joseph A Himle5, Dexia Kong6, Qingying Ji7. 1. University of Michigan, School of Social Work, United States; Shanghai Children's Medical Center, China. Electronic address: zhangan@umich.edu. 2. The University of Texas at Austin, Steve Hicks School of Social Work, United States. 3. East China University of Political Science and Law, School of Social Development, China. 4. University of Michigan, School of Social Work, United States. 5. University of Michigan, School of Social Work, United States; University of Michigan, Department of Psychiatry. 6. Rutgers, The State University of New Jersey, Institute for Health, Health Care Policy and Aging Research, United States. 7. Shanghai Children's Medical Center, China.
Abstract
BACKGROUND: Depressive and anxiety disorders are highly prevalent and detrimental in primary care settings. However, there are gaps in the literature concerning effectiveness and generalizability of empirically supported interventions and treatment of both depression and anxiety in primary care settings. The aim of this review is to systematically assess and meta-analyze the effectiveness of brief empirically-supported psychotherapies for treating depression and/or anxiety in primary care. METHODS: Seven electronic databases, five professional websites and manual search of reference lists were searched through April 2017 for randomized controlled trials (RCTs) of four psychotherapies treating primary care depression and anxiety: cognitive-behavior therapy (CBT), problem-solving therapy (PST), motivational interviewing (MI), and solution-focused brief therapy (SFBT). RESULTS: From an initial pool of 1140 articles, 179 articles were eligible for full-text review and 65 articles were included for final analysis. Sixty-five articles containing 198 effect sizes reported an overall treatment effect size of d = 0.462, p < 0.001. Single-predictor meta-regression indicated that marital status, treatment modality (individual versus group), and treatment composition were significant moderators. Multiple-predictor meta-regression discovered treatment setting (inside versus outside primary care) significantly moderated treatment effect, b = -0.863, p = 0.039 after controlling for other intervention characteristics. CONCLUSION: Treatment effects were found for CBT and PST, both for depressive and anxiety disorders. Interventions delivered outside primary care settings were more effective than those within, individual treatment had greater treatment effects compared to group treatment, and both technology-assisted and in-person treatments were found to be effective.
BACKGROUND:Depressive and anxiety disorders are highly prevalent and detrimental in primary care settings. However, there are gaps in the literature concerning effectiveness and generalizability of empirically supported interventions and treatment of both depression and anxiety in primary care settings. The aim of this review is to systematically assess and meta-analyze the effectiveness of brief empirically-supported psychotherapies for treating depression and/or anxiety in primary care. METHODS: Seven electronic databases, five professional websites and manual search of reference lists were searched through April 2017 for randomized controlled trials (RCTs) of four psychotherapies treating primary care depression and anxiety: cognitive-behavior therapy (CBT), problem-solving therapy (PST), motivational interviewing (MI), and solution-focused brief therapy (SFBT). RESULTS: From an initial pool of 1140 articles, 179 articles were eligible for full-text review and 65 articles were included for final analysis. Sixty-five articles containing 198 effect sizes reported an overall treatment effect size of d = 0.462, p < 0.001. Single-predictor meta-regression indicated that marital status, treatment modality (individual versus group), and treatment composition were significant moderators. Multiple-predictor meta-regression discovered treatment setting (inside versus outside primary care) significantly moderated treatment effect, b = -0.863, p = 0.039 after controlling for other intervention characteristics. CONCLUSION: Treatment effects were found for CBT and PST, both for depressive and anxiety disorders. Interventions delivered outside primary care settings were more effective than those within, individual treatment had greater treatment effects compared to group treatment, and both technology-assisted and in-person treatments were found to be effective.
Authors: Marit Knapstad; Linn Vathne Lervik; Solbjørg Makalani Myrtveit Sæther; Leif Edvard Aarø; Otto Robert F Smith Journal: Psychother Psychosom Date: 2019-12-03 Impact factor: 17.659
Authors: Justus Tönnies; Mechthild Hartmann; Michel Wensing; Joachim Szecsenyi; Andrea Icks; Hans-Christoph Friederich; Markus W Haun Journal: BMJ Open Date: 2019-09-04 Impact factor: 2.692
Authors: Justus Tönnies; Mechthild Hartmann; Michel Wensing; Joachim Szecsenyi; Frank Peters-Klimm; Regina Brinster; Dorothea Weber; Markus Vomhof; Andrea Icks; Hans-Christoph Friederich; Markus W Haun Journal: JMIR Ment Health Date: 2021-03-12
Authors: Markus W Haun; Justus Tönnies; Regina Krisam; Dorothea Kronsteiner; Michel Wensing; Joachim Szecsenyi; Markus Vomhof; Andrea Icks; Beate Wild; Mechthild Hartmann; Hans-Christoph Friederich Journal: Trials Date: 2021-05-05 Impact factor: 2.279