Bridget Hogg1, Joan Carles Medina2, Itxaso Gardoki-Souto1, Ilinca Serbanescu3, Ana Moreno-Alcázar4, Arlinda Cerga-Pashoja5, Evelien Coppens6, Mónika Ditta Tóth7, Naim Fanaj8, Birgit A Greiner9, Carolyn Holland10, Kairi Kõlves11, Margaret Maxwell12, Gentiana Qirjako13, Lars de Winter14, Ulrich Hegerl15, Victor Pérez-Sola16, Ella Arensman17, Benedikt L Amann18. 1. Centre Fòrum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; PhD Programme, Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain. 2. Faculty of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain; Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain. 3. European Alliance Against Depression e.V., Leipzig, Germany; Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany. 4. Centre Fòrum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBERSAM, Madrid, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain. 5. Population Health, London School of Hygiene and Tropical Medicine, London, England; Global Public Health, Public Health England, United Kingdom. 6. LUCAS, Centre for Care Research and Consultancy, University of Leuven, Belgium. 7. Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary. 8. Mental Health Center Prizren, Kosovo. 9. School of Public Health, College of Medicine and Health, National Suicide Research Foundation, University College Cork, Ireland. 10. National Suicide Research Foundation, Cork, Ireland; Health Service Executive, Cork, Ireland. 11. Australian Institute for Suicide Research and Prevention, Griffith University. 12. Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Scotland, United Kingdom. 13. Department of Public Health, Faculty of Medicine, University of Medicine, Tirana, Albania. 14. Phrenos Center of Expertise for severe mental illness, Utrecht, the Netherlands. 15. European Alliance Against Depression e.V., Leipzig, Germany; Research Centre of the German Depression Foundation, Leipzig, Germany; Department of Psychiatry, Psychosomatics and Psychotherapy, Goethe-Universität Frankfurt, Frankfurt, Germany. 16. IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBERSAM, Madrid, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain; Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Barcelona, Spain. 17. School of Public Health, College of Medicine and Health, National Suicide Research Foundation, University College Cork, Ireland; National Suicide Research Foundation, Cork, Ireland; Australian Institute for Suicide Research and Prevention, Griffith University; International Association for Suicide Prevention (IASP), Washington DC, USA. Electronic address: ella.arensman@ucc.ie. 18. Centre Fòrum Research Unit, Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBERSAM, Madrid, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine Universitat Autònoma de Barcelona, Barcelona, Spain; Institut de Neuropsiquiatria i Addiccions (INAD), Hospital del Mar, Barcelona, Spain.
Abstract
BACKGROUND: Depression and anxiety are the most prevalent mental health difficulties in the workplace, costing the global economy $1 trillion each year. Evidence indicates that symptoms may be reduced by interventions in the workplace. This paper is the first to systematically review psychosocial interventions for depression, anxiety, and suicidal ideation and behaviours in small-to medium-size enterprises (SMEs). METHODS: A systematic search following PRISMA guidelines, registered in PROSPERO (CRD42020156275), was conducted for psychosocial interventions targeting depression, anxiety, and suicidal ideation/behaviour in SMEs. The PubMed, PsycINFO, Scopus, and two specific occupational health databases were searched, as well as four databases for grey literature, without time limit until 2nd December 2019. RESULTS: In total, 1283 records were identified, 70 were retained for full-text screening, and seven met the inclusion criteria: three randomised controlled trials (RCTs), three before and after designs and one non-randomised trial, comprising 5111 participants. Study quality was low to moderate according to the Quality Assessment Tool for Quantitative Studies. Five studies showed a reduction in depression and anxiety symptoms using techniques based on cognitive behavioural therapy (CBT), two reported no significant change. LIMITATIONS: Low number and high heterogeneity of interventions and outcomes, high attrition and lack of rigorous RCTs. CONCLUSIONS: Preliminary evidence indicates CBT-based interventions can be effective in targeting symptoms of depression and anxiety in SME employees. There may be unique challenges to implementing programmes in SMEs. Further research is needed in this important area.
BACKGROUND: Depression and anxiety are the most prevalent mental health difficulties in the workplace, costing the global economy $1 trillion each year. Evidence indicates that symptoms may be reduced by interventions in the workplace. This paper is the first to systematically review psychosocial interventions for depression, anxiety, and suicidal ideation and behaviours in small-to medium-size enterprises (SMEs). METHODS: A systematic search following PRISMA guidelines, registered in PROSPERO (CRD42020156275), was conducted for psychosocial interventions targeting depression, anxiety, and suicidal ideation/behaviour in SMEs. The PubMed, PsycINFO, Scopus, and two specific occupational health databases were searched, as well as four databases for grey literature, without time limit until 2nd December 2019. RESULTS: In total, 1283 records were identified, 70 were retained for full-text screening, and seven met the inclusion criteria: three randomised controlled trials (RCTs), three before and after designs and one non-randomised trial, comprising 5111 participants. Study quality was low to moderate according to the Quality Assessment Tool for Quantitative Studies. Five studies showed a reduction in depression and anxiety symptoms using techniques based on cognitive behavioural therapy (CBT), two reported no significant change. LIMITATIONS: Low number and high heterogeneity of interventions and outcomes, high attrition and lack of rigorous RCTs. CONCLUSIONS: Preliminary evidence indicates CBT-based interventions can be effective in targeting symptoms of depression and anxiety in SME employees. There may be unique challenges to implementing programmes in SMEs. Further research is needed in this important area.