Objectives
Co‐occurring mood and anxiety disorders are common in older adult populations and are associated with worse long‐term outcomes and poorer treatment response than either disorder alone. This systematic review and meta‐analysis aimed to examine the efficacy and effectiveness of psychological interventions for treating co‐occurring mood and anxiety disorders in older adults.
Method
The study was registered (PROSPERO CRD4201603834), databases systematically searched (MEDLINE, PSYCINFO, PubMed and Cochrane Reviews) and articles screened according to PRISMA guidelines.
Inclusion
Participants aged ≥60 years with clinically significant anxiety and depression, psychological intervention evaluated against control in randomised controlled trial, changes in both anxiety and depression reported at post‐treatment. ResultsFour studies were included (total n = 255, mean age range 67–71 years). Overall, psychological interventions (cognitive behavioural therapy, mindfulness) resulted in significant benefits over control conditions (active, waitlist) for treating depression in the presence of co‐occurring anxiety (Hedges' g = −0.44), and treating anxiety in the presence of depression (Hedges' g = −0.55). However, conclusions are limited; the meta‐analysis was non‐significant, few studies were included, several were low quality and there was high heterogeneity between studies. Benefits at follow‐up were not established.
Conclusion
Co‐occurring anxiety and mood disorders can probably be treated simultaneously with psychological interventions in older adults with moderate effect sizes, however, more research is needed. Given comorbidity is common and associated with worse clinical outcomes, more high‐quality clinical trials are needed that target the treatment of co‐occurring anxiety and mood disorders, and report changes in diagnostic remission for both anxiety and mood disorders independently.
The final year of secondary school has been shown to be associated with heightened student stress. Psychological interventions have been shown to be effective in reducing and preventing distress in students during this school period, although the widespread adoption of these interventions into school settings is limited. There have been recent calls for research to examine the implementation success of evidence‐based programmes when used by schools in school settings. The present study aimed to evaluate the implementation success of an evidence‐based cognitive‐behavioural therapy programme (Study without Stress) using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE‐AIM) framework. At one Australian high school, all tutor group teachers were trained by the school counsellor to deliver the programme in standard school classes to students in the lead up to their final year of secondary school. Students (n = 80) and teachers (n = 11) reported on programme success against the RE‐AIM framework at pre‐intervention, post‐intervention, and three‐month follow‐up. The findings indicated that SWOS was implemented successfully by the school. SWOS was associated with maintaining student stress levels at normal levels over time, as well as reducing the severity of stress for initially highly distressed students. The findings provide evidence from implementation science that SWOS can be adapted and delivered effectively by school staff to manage stress in final year secondary school students.
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