Effectiveness of a stepped care intervention for anxiety and depression in people with diabetes, asthma or COPD in primary care: A randomized controlled trial

Stoop, Corinne; Nefs, Giesje; Pommer, Antoinette M.; Pop, Victor J M; Pouwer, Frans

doi:10.1016/j.jad.2015.05.063

Cited by 53 publications

(88 citation statements)

References 40 publications

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“…Depressive and anxiety symptoms were assessed in all but one study, which included a QoL outcome (Kuijer et al, 2007 ). Depressive symptoms were assessed using the Centre for Epidemiologic Studies Depression scale (CES-D) in two studies (Penckofer et al, 2012 ; Huang et al, 2015 ), the 9-item Patient Health Questionnaire (PHQ-9) in two studies (Rosland et al, 2015 ; Stoop et al, 2015 ), and the Beck Depression Inventory II (BDI) in one study (Moncrieft et al, 2016 ). Anxiety was measured in three studies and was assessed using the Crown-Crisp Experiential Index (CCEI) somatic anxiety subscale in one study (D'Eramo Melkus et al, 2010 ), the State Trait Anxiety Inventory (STAI) in one study (Penckofer et al, 2012 ) and the 7-item Generalized Anxiety Disorder questionnaire (GAD-7) in one study (Stoop et al, 2015 ).…”

Section: Resultsmentioning

confidence: 99%

“…In two studies the authors were contacted and they advised that individuals collecting outcome measures were blinded (D'Eramo Melkus et al, 2010 ; Rosland et al, 2015 ). In two studies relevant means and standard deviations for outcomes of interest were not reported in the text and were provided by the authors upon request (completers) (D'Eramo Melkus et al, 2010 ; Stoop et al, 2015 ). Data were extracted independently by two reviewers and disagreements were resolved through discussion or by consulting a third reviewer.…”

Section: Methodsmentioning

confidence: 99%

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Psychosocial Interventions and Wellbeing in Individuals with Diabetes Mellitus: A Systematic Review and Meta-Analysis

et al. 2017

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Purpose: A number of studies, including systematic reviews, show beneficial effects of psychosocial interventions for people with diabetes mellitus; however, they have not been assessed using meta-analysis. The purpose of this meta-analysis of randomized controlled trials is to investigate the effects of psychosocial interventions on depressive and anxiety symptoms, quality of life and self-efficacy in individuals with diabetes mellitus.Methods: The databases Pubmed, MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science and SocINDEX were searched with no year restriction. Eligible studies were randomized controlled trials published in English that included individuals diagnosed with diabetes mellitus, aged 18 years or above, who engaged in a psychosocial intervention, with outcome measures addressing depressive or anxiety symptomology, quality of life or self-efficacy. Eligible studies needed to compare the intervention to usual care. Study selection was completed using Covidence and meta-analysis was undertaken using Comprehensive Meta-Analysis software.Results: Seven studies were included in the meta-analysis. Five studies investigated the effects of psychosocial interventions and showed a medium to large benefit for depressive symptoms (SMD: −0.70; CI: −1.27, −0.13) which persisted at follow up (SMD: −1.54, CI: −2.97, −0.12). Similar results were not seen immediately post-intervention in the three studies that assessed anxiety symptoms (SMD: −0.30; CI: −0.69, 0.10); however, a medium beneficial effect was seen at follow up (SMD = −0.61, CI = −0.92 to −0.31). Small benefits were seen in the three studies assessing quality of life outcomes (SMD: 0.30, CI: 0.06, 0.55). No benefit was seen in the two studies assessing self-efficacy (SMD: 0.23, CI: −0.11, 0.57).Conclusions: The results of the current study provide preliminary evidence that psychosocial interventions, compared to usual care, reduce depressive symptoms, and may improve quality of life in individuals with diabetes. However, only a few studies were included and the clinical significance of these findings is unknown.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Psychosocial Interventions and Wellbeing in Individuals with Diabetes Mellitus: A Systematic Review and Meta-Analysis

et al. 2017

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“…Participants who were receiving long‐term oxygen therapy, cognitive impairment treatment, cancer treatment and other types of mind–body‐related interventions in the past three months were excluded from the study. An estimation of sample size was calculated at an effect size of 0.25 on the primary outcome of anxiety (Stoop, Nefs, Pommer, Pop, & Pouwer, ). According to G power 3.1.7, F test of repeated measures was done four times for the two groups (Faul, Erdfelder, Lang, & Buchner, ); to reach 80% power and α at 0.05, a target sample size of 82 was estimated.…”

Section: Methodsmentioning

confidence: 99%

“…An estimation of sample size was calculated at an effect size of 0.25 on the primary outcome of anxiety (Stoop, Nefs, Pommer, Pop, & Pouwer, 2015). According to G power 3.1.7, F test of repeated measures was done four times for the two groups (Faul, Erdfelder, Lang, & Buchner, 2007); to reach 80% power and α at 0.05, a target sample size of 82 was estimated.…”

Section: Participantsmentioning

confidence: 99%

Two‐month breathing‐based walking improves anxiety, depression, dyspnoea and quality of life in chronic obstructive pulmonary disease: A randomised controlled study

Lin

Yeh

Lai

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To examine the effects of the two‐month breathing‐based walking intervention and its follow‐up on anxiety, depression, dyspnoea and quality of life in patients with chronic obstructive pulmonary disease. Background Mind–body‐related exercises improve bio‐psychological symptoms and quality of life in chronic diseases, but these improvements are not proven for chronic obstructive pulmonary disease. Design This was a randomised controlled study and applied the Consolidated Standards of Reporting Trials (CONSORT) statement. Methods Outpatients diagnosed with chronic obstructive pulmonary disease were recruited from a medical centre in Taiwan and randomly assigned to two groups. The walking group (n = 42) received breathing, meditation and walking for two months, and the control group (n = 42) did not. Data from the outcomes of anxiety, depression, dyspnoea and quality of life were collected at baseline and in Month 1, Month 2 and Month 3. Clinical trial registration was done (ClinicalTrials.gov.: NCT03388489). Findings The results showed significant changes in anxiety, depression, dyspnoea and quality of life in the walking group across three months, compared to those in the control group and at baseline. Conclusion This breathing‐based walking intervention is promising to achieve bio‐psychological well‐being for patients with chronic obstructive pulmonary disease. Relevance to clinical practice This breathing‐based walking, as a mind–body exercise, could serve as an evidence‐based nursing care that contributes to improving anxiety, depression, dyspnoea and quality of life in stable chronic obstructive pulmonary disease outpatients. The feasibility and acceptability of the breathing‐based walking were met the requirement of the chronic obstructive pulmonary disease outpatients, which could be considered as home‐based exercise.

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“…People with diabetes and major and minor depression have a 2.3-and 1.67-fold increase in mortality, respectively, compared to those without depression. There is strong evidence of an increased risk of depression in people with diabetes as well as increased risk of developing diabetes in people with depression [27]. More importantly, there is a body of evidence that collaborative care for depression improves glycemic control [28,29].…”

Section: Diabetesmentioning

confidence: 99%

Psychiatric and Medical Comorbidity in the Primary Care Geriatric Patient—An Update

Kennedy

Castro

Chang

et al. 2016

Curr Psychiatry Rep

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The mental health needs of older primary care patients are now widely recognized if not widely addressed. The range of behavioral health approaches including co-locating psychiatrists and integrating mental health professionals as care managers into primary care sites is extensive and growing. Nonetheless the primary care provider remains the first line of defense against mental disorders, most commonly depression and anxiety that accompany and exacerbate common physical conditions. The excess, potentially avoidable disability that results from comorbidity makes it imperative that early recognition and evidence based intervention occur. Multi-morbidity and polypharmacy make intervention a challenge. Psychotherapy can help overcome comorbidity depression however the most accessible intervention would be an antidepressant FDA approved for both anxiety and depressive disorders. For all these reasons, a focus on physical conditions most commonly associated with mental disorders can foster early recognition before the older patient's care becomes overwhelmingly complicated.

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Effectiveness of a stepped care intervention for anxiety and depression in people with diabetes, asthma or COPD in primary care: A randomized controlled trial

Cited by 53 publications

References 40 publications

Psychosocial Interventions and Wellbeing in Individuals with Diabetes Mellitus: A Systematic Review and Meta-Analysis

Psychosocial Interventions and Wellbeing in Individuals with Diabetes Mellitus: A Systematic Review and Meta-Analysis

Two‐month breathing‐based walking improves anxiety, depression, dyspnoea and quality of life in chronic obstructive pulmonary disease: A randomised controlled study

Psychiatric and Medical Comorbidity in the Primary Care Geriatric Patient—An Update

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