The clinical effectiveness of concise cognitive behavioral therapy with or without pharmacotherapy for depressive and anxiety disorders; a pragmatic randomized controlled equivalence trial in clinical practice

Abstract

. (2016). The clinical effectiveness of concise cognitive behavioral therapy with or without pharmacotherapy for depressive and anxiety disorders; a pragmatic randomized controlled equivalence trial in clinical practice. Contemporary Clinical Trials, 47 131-138. See next page for additional authorsThe clinical effectiveness of concise cognitive behavioral therapy with or without pharmacotherapy for depressive and anxiety disorders; a pragmatic randomized controlled equivalence trial in clinical practice Abstract Background: Depressive and anxiety disorders contribute to a high disease burden. This paper investigates whether concise formats of cognitive behavioral-and/or pharmacotherapy are equivalent with longer standard care in the treatment of depressive and/or anxiety disorders in secondary mental health care. Methods: A pragmatic randomized controlled equivalence trial was conducted at five Dutch outpatient Mental Healthcare Centers (MHCs) of the Regional Mental Health Provider (RMHP) 'Rivierduinen'. Patients (aged 18-65 years) with a mild to moderate anxiety and/or depressive disorder, were randomly allocated to concise or standard care. Data were collected at baseline, 3, 6 and 12 months by Routine Outcome Monitoring (ROM). Primary outcomes were the Brief Symptom Inventory (BSI) and the Web Screening Questionnaire (WSQ). We used Generalized Estimating Equations (GEE) to assess outcomes. Results: Between March 2010 and December 2012, 182 patients, were enrolled (n = 89 standard care; n = 93 concise care). Both intention-to-treat and per-protocol analyses demonstrated equivalence of concise care and standard care at all time points. Severity of illness reduced, and both treatments improved patient's general health status and subdomains of quality of life. Moreover, in concise care, the beneficial effects started earlier. Discussion: Concise care has the potential to be a feasible and promising alternative to longer standard secondary mental health care in the treatment of outpatients with a mild to moderate depressive and/or anxiety disorder. For future research, we recommend adhering more strictly to the concise treatment protocols to further explore the beneficial effects of the concise treatment. Moreover, in concise care, the beneficial effects started earlier.

The Effect of Cognitive-Behavioral Group Therapy on Anger and General Health of Female Students in Iran: A Pilot Study

“…This result is con-gruent with those of Meuldijk et al (30). During initial sessions of therapy, it was observed that there was a reciprocal relation between anger and some parts of anxiety in the participants of this study, leading to a vicious circle; which meant that participants could not express their anger in an appropriate, sensible way probably due to a hidden social anxiety that prevents them from expression of anger.…”

“…There was a significant difference in the mean scores of general health between the experimental and control groups in the post-test and follow-up. This result is congruent with those of Meuldijk et al (30). General health is a construct that can be evaluated based on physical and psychological conditions of individuals including psychological distress (anxiety, depression, etc.…”

The Benefits of Psychosocial Interventions for Mental Health in People Living with HIV: A Systematic Review and Meta-analysis

“…However, there is a trend toward designing concise treatments for mental health problems, which can be provided via the Internet and are thought to be more cost-effective. An RCT that compared the effectiveness of concise CBT with standard CBT for depression and anxiety found that they were equivalent [ 103 ]. Most previous meta-analyses that have investigated the effectiveness of psychological interventions for depression or anxiety have also found no differences between treatments with a short or long duration [ 14 , 95 , 97 , 101 , 102 ].…”

A Psychosocial Intervention for Mental Health of People With Hiv (Plwh): A Literature Review

“…According to Leunen et al, (2017) (11) studies with a duration of treatment ranging from 12-18 hours have a more significant effect than the length of short or longer treatments. However, an RCT that compared the effectiveness of a concise CBT and standard CBT in PLWH with depression and anxiety showed similar effectiveness (64). Several meta-analyses that investigated the efficacy of psychological interventions for depression and anxiety for PLWH also found no difference between short or long duration treatments (29)(30)63).…”