Predictors of outcomes for patients with common mental health disorders receiving psychological therapies in community settings: a systematic review

Amati, Federica; Banks, Christina; Greenfield, Geva; Green, J

doi:10.1093/pubmed/fdx168

Cited by 26 publications

(25 citation statements)

References 35 publications

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“…In a systematic review investigating social anxiety disorder, Mululo, de Menezes, Vigne, and Fontenelle (2012) found that early onset, greater severity, and comorbidity resulted in less favorable treatment outcomes. The finding related to comorbidity is congruent with other reviews investigating predictors of treatment outcomes that have found comorbid depression is related to poorer treatment outcomes (Amati, Banks, Greenfield, & Green, 2017;Eskildsen, Hougaard, & Rosenberg, 2010). An additional review by Vall & Wade (2015) found that lower motivation significantly related to dropout (r=.23) and fewer familial problems related to a more favorable overall outcome (r=.36).…”

Section: Future Directionssupporting

confidence: 86%

Bucher et al. Personality traits and treatment outcomes meta-analysis

Bucher¹,

Suzuki²,

Samuel³

2019

Preprint

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Personality traits have been hypothesized to be clinically useful for diagnosis, client conceptualization, treatment planning, as well as for predicting treatment outcomes. Although several studies examined the relation between personality traits and specific therapy outcomes, this literature has not yet been systematically reviewed. Thus, the purpose of the current study was to investigate the relations between personality traits and various therapeutic outcomes. Traits were organized via the domains of the five-factor model to provide a common framework for interpreting effects. Across 99 studies (N=107,206), overall findings indicated that traits were systematically related to outcomes, with many specific relations congruent with theorized predictions. Generally, lower levels of neuroticism and higher levels of extraversion, agreeableness, conscientiousness, and openness were associated with more favorable outcomes. More specifically, agreeableness had positive associations with therapeutic alliance and conscientiousness was positively related to abstinence from substances suggesting these traits are likely a beneficial factor to consider at the outset of services. Personality traits also related to various outcomes differently based on moderators. For example, duration of treatment moderated links between traits and outcomes suggesting these effects are amplified over longer services. Overall results suggest that personality assessment can aid with case conceptualization by suggesting potential strengths as well as barriers to treatment.

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Section: Future Directionssupporting

confidence: 86%

Bucher et al. Personality traits and treatment outcomes meta-analysis

Bucher¹,

Suzuki²,

Samuel³

2019

Preprint

View full text Add to dashboard Cite

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“…Contrary to our findings, a systematic review on the predictors of recovery in people with CMDs in commmunity settings, in high-income countries found that socio-economic status did not have a direct impact on treatment outcome. However, the same review also found evidence that socioeconomic status had an impact on baseline depression scores, which is itself a predictor of outcome (Amati et al ., 2017). The evidence on the impact of socioeconomic status on mental health outcomes between low- and middle-income countries and high-income countries, do not always align.…”

Section: Discussionmentioning

confidence: 99%

“…Our study found that the male gender was associated with a higher GAD-7 score reduction, compared to females. In contrast, a systematic review on the predictors of treatment outcome for people with CMDs, found that being female was associated with positive treatment outcomes for patients receiving psychological therapies in high-income countries (Amati et al ., 2017). Similarly, a study investigating the effectiveness of collaborative care for anxiety when compared to usual care found that women who received collaborative treatment showed clinical improvements, while no differences were found for men.…”

Section: Discussionmentioning

confidence: 99%

A community health volunteer delivered problem-solving therapy mobile application based on the Friendship Bench ‘Inuka Coaching’ in Kenya: A pilot cohort study

Doukani

Dalen²,

Valev

et al. 2021

Glob. Ment. Health

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Background Sub-Saharan Africa (SSA) has the largest care gap for common mental disorders (CMDs) globally, heralding the use of cost-cutting approaches such as task-shifting and digital technologies as viable approaches for expanding the mental health workforce. This study aims to evaluate the effectiveness of a problem-solving therapy (PST) intervention that is delivered by community health volunteers (CHVs) through a mobile application called ‘Inuka coaching’ in Kenya. Methods A pilot prospective cohort study recruited participants from 18 health centres in Kenya. People who self-screened were eligible if they scored 8 or higher on the Self-Reporting Questionnaire-20 (SRQ-20), were aged 18 years or older, conversant in written and spoken English, and familiar with the use of smart mobile devices. The intervention consisted of four PST mobile application chat-sessions delivered by CHVs. CMD measures were administered at baseline, 4-weeks (post-treatment), and at 3-months follow-up assessment. Results In all, 80 participants consented to the study, of which 60 participants (female, n = 38; male, n = 22) completed their 4-week assessments, and 52 participants completed their 3-month follow-up assessment. The results showed a significant improvement over time on the Self-Reporting Questionnaire-20 (SRQ-20). Higher-range income, not reporting suicidal ideation, being aged over 30 years, and being male were associated with higher CMD symptom reduction. Conclusion To our knowledge, this report is the first to pilot a PST intervention that is delivered by CHVs through a locally developed mobile application in Kenya, to which clinically meaningful improvements were found. However, a randomised-controlled trial is required to robustly evaluate this intervention.

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“…Models of mental health recognize that mental health is influenced by individuals (eg, symptoms), social (eg, work stress), and environmental (eg, access to service and injustice) factors [15]. At the individual level, those involved with ICs may have greater symptom severity, which has been associated with poorer treatment outcomes [16]. Specifically, ICs often have requirements for the severity or duration of symptoms before a disability claim can be granted, especially long-term disability, which may contribute to more severe symptoms in IC groups [17].…”

Section: Outcomes In Insurance Company Clientsmentioning

confidence: 99%

“…The Patient Health Questionnaire-9 (PHQ-9) [31] is a 9-item validated self-report questionnaire that is used to assess depression symptom severity. Total scores range from 0 to 27 with scores being interpreted as indicative of mild (5-9), moderate (10)(11)(12)(13)(14), moderately severe (15)(16)(17)(18)(19), and severe (20)(21)(22)(23)(24)(25)(26)(27) depressive symptoms [32]. A cut-off score of 10 or higher is used to identify those who are likely to have a diagnosis of depression [20].…”

Section: Patient Health Questionnaire 9-itemmentioning

confidence: 99%

An Internet-Delivered Cognitive Behavioral Therapy for Depression and Anxiety Among Clients Referred and Funded by Insurance Companies Compared With Those Who Are Publicly Funded: Longitudinal Observational Study

et al. 2020

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Background Anxiety and depression are leading causes of disability but are often undertreated. Internet-delivered cognitive behavioral therapy (ICBT) improves access to treatment by overcoming barriers to obtaining care. ICBT has been found to be efficacious in research trials and routine care, but there is limited research of ICBT when it is recommended and funded by insurance companies for clients on or recently in receipt of disability benefits or accommodations. Objective The aim of this study was to examine ICBT engagement, treatment satisfaction, and effectiveness among individuals involved with 2 insurance companies. The 2 samples were benchmarked against published outcomes from a publicly funded (PF) ICBT clinic. Methods Individuals who were on or recently in receipt of disability benefits and were either insurance company (IC) employees (n=21) or IC plan members (n=19) were referred to ICBT funded by the respective insurance companies. Outcomes were benchmarked against outcomes of ICBT obtained in a PF ICBT clinic, with clients in the clinic divided into those who reported no involvement with insurance companies (n=414) and those who were on short-term disability (n=44). All clients received the same 8-week, therapist-assisted, transdiagnostic ICBT course targeting anxiety and depression. Engagement was assessed using completion rates, log-ins, and emails exchanged. Treatment satisfaction was assessed posttreatment. Depression, anxiety, and disability measures were administered pretreatment, posttreatment, and at 3 months. Results All samples showed high levels of ICBT engagement and treatment satisfaction. IC employees experienced significant improvement at posttreatment (depression d=0.77; anxiety d=1.13; and disability d=0.91) with outcomes maintained at 3 months. IC plan members, who notably had greater pretreatment disability than the other samples, experienced significant moderate effects at posttreatment (depression d=0.58; anxiety d=0.54; and disability d=0.60), but gains were not maintained at 3 months. Effect sizes at posttreatment in both IC samples were significantly smaller than in the PF sample who reported no insurance benefits (depression d=1.14 and anxiety d=1.30) and the PF sample who reported having short-term disability benefits (depression d=0.95 and anxiety d=1.07). No difference was seen in effect sizes among IC employees and the PF samples on disability. However, IC plan members experienced significantly smaller effects on disability d=0.60) compared with the PF sample with no disability benefits d=0.90) and those on short-term disability benefits d=0.94). Conclusions Many clients referred and funded by insurance companies were engaged with ICBT and found it acceptable and effective. Results, however, were not maintained among those with very high levels of pretreatment disability. Small sample sizes in the IC groups are a limitation. Directions for research related to ICBT funded by insurance companies have been described.

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Predictors of outcomes for patients with common mental health disorders receiving psychological therapies in community settings: a systematic review

Abstract: We identified key predictors for recovery in a community settings from five countries. The evidence currently available for this setting is limited, so this review serves as a starting point to highlight key factors that warrant further investigation.

Cited by 26 publications

References 35 publications

Bucher et al. Personality traits and treatment outcomes meta-analysis

Bucher et al. Personality traits and treatment outcomes meta-analysis

A community health volunteer delivered problem-solving therapy mobile application based on the Friendship Bench ‘Inuka Coaching’ in Kenya: A pilot cohort study

An Internet-Delivered Cognitive Behavioral Therapy for Depression and Anxiety Among Clients Referred and Funded by Insurance Companies Compared With Those Who Are Publicly Funded: Longitudinal Observational Study

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