Effectiveness and implementation of psychological interventions for depression in people with non-communicable diseases in South Asia: Systematic review and meta-analysis

TY - JOUR

T1 - Effectiveness and implementation of psychological interventions for depression in people with non-communicable diseases in South Asia

T2 - Systematic review and meta-analysis

AU - Zavala Gomez, Gerardo Antonio

AU - Jennings, Hannah Maria

AU - Afaq, Saima

AU - Alam, Ashraful

AU - Ahmed, Naveed

AU - Aslam, Faiza

AU - Arsh, Aatik

AU - Coales, Karen

AU - Ekers, David Michael

AU - Nabi, Mumtahanah

AU - Naz, Anum

AU - Shakur, Nayeema

AU - Siddiqi, Najma

AU - Wright, Judy M

AU - Kellar, Ian

N1 - © 2023 The Author(s).

PY - 2023/4/24

Y1 - 2023/4/24

N2 - We evaluate the effectiveness of psychological interventions for depression in people with NCDs in South Asia and explore the individual, organizational, and policy-level barriers and facilitators for the implementation and scaling up of these interventions. Eight databases (and local web pages) were searched in May 2022. We conducted random effects models to evaluate the pooled effect of psychological interventions on depression in people with NCDs. We extracted the individual, organizational, and policy level barriers and facilitators. We found five randomized control trials, nine qualitative studies, and 35 policy documents that fitted the inclusion criteria. The pooled standardized mean difference in depression comparing psychological interventions with usual care was -2.31 (95% CI, -4.16 to -0.45; p = .015, I 2 = 96.0%). We found barriers and facilitators to intervention delivery, mental health appears in the policy agenda in Bangladesh and Pakistan. However, there is a lack of policies relating to training in mental health for NCD health providers and a lack of integration of mental health care with NCD care. All of the psychological interventions reported to be effective in treating depression in this population. There are important delivery and policy barriers to the implementation and scaling up of psychological interventions for people with NCDs.

AB - We evaluate the effectiveness of psychological interventions for depression in people with NCDs in South Asia and explore the individual, organizational, and policy-level barriers and facilitators for the implementation and scaling up of these interventions. Eight databases (and local web pages) were searched in May 2022. We conducted random effects models to evaluate the pooled effect of psychological interventions on depression in people with NCDs. We extracted the individual, organizational, and policy level barriers and facilitators. We found five randomized control trials, nine qualitative studies, and 35 policy documents that fitted the inclusion criteria. The pooled standardized mean difference in depression comparing psychological interventions with usual care was -2.31 (95% CI, -4.16 to -0.45; p = .015, I 2 = 96.0%). We found barriers and facilitators to intervention delivery, mental health appears in the policy agenda in Bangladesh and Pakistan. However, there is a lack of policies relating to training in mental health for NCD health providers and a lack of integration of mental health care with NCD care. All of the psychological interventions reported to be effective in treating depression in this population. There are important delivery and policy barriers to the implementation and scaling up of psychological interventions for people with NCDs.

U2 - 10.1080/00207411.2023.2202431

DO - 10.1080/00207411.2023.2202431

M3 - Article

C2 - 38013979

SN - 0020-7411

VL - 52

SP - 260

EP - 284

JO - International journal of mental health

JF - International journal of mental health

IS - 3

ER -