Impact of long-term medical conditions on the outcomes of psychological therapy for depression and anxiety

Jaime Delgadillo; Alexander Dawson; Simon Martin Gilbody; Jan Rasmus Boehnke

doi:10.1192/bjp.bp.116.189027

Impact of long-term medical conditions on the outcomes of psychological therapy for depression and anxiety

Jaime Delgadillo, Alexander Dawson, Simon Martin Gilbody, Jan Rasmus Boehnke

The Hull York Medical School

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Long-term conditions often coexist with depression and anxiety.

AIMS: To assess the effectiveness of stepped-care psychological therapies for patients with long-term conditions.

METHOD: Data from 28 498 patients were analysed using regression to model depression (Patient Health Questionnaire (PHQ-9)) and anxiety (Generalised Anxiety Disorder scale (GAD-7)) outcomes. Post-treatment symptoms and effect sizes (d) were estimated for individuals with and without long-term conditions, controlling for covariates. The likelihood of access and response to intensive psychological interventions was also examined.

RESULTS: Higher post-treatment symptoms were predicted for patients with musculoskeletal problems (d = 0.22-0.27), chronic obstructive pulmonary disease (d = 0.26-0.33), diabetes (d = 0.05-0.13) and psychotic disorders (d = 0.50-0.58). Most long-term conditions were associated with greater odds of accessing high-intensity therapies, yet individuals who accessed these continued to have higher average post-treatment symptoms.

CONCLUSIONS: Some long-term conditions are associated with greater intensity of care and poorer outcomes after therapy.

Original language	English
Number of pages	7
Journal	The British journal of psychiatry
Volume	209
Issue number	5
DOIs	https://doi.org/10.1192/bjp.bp.116.189027
Publication status	Published - 17 Nov 2016

Bibliographical note

© The Royal College of Psychiatrists 2016. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details

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10.1192/bjp.bp.116.189027

BJP-2016-189027-revision
© The Royal College of Psychiatrists 2016. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details
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Cite this

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title = "Impact of long-term medical conditions on the outcomes of psychological therapy for depression and anxiety",

abstract = "BACKGROUND: Long-term conditions often coexist with depression and anxiety.AIMS: To assess the effectiveness of stepped-care psychological therapies for patients with long-term conditions.METHOD: Data from 28 498 patients were analysed using regression to model depression (Patient Health Questionnaire (PHQ-9)) and anxiety (Generalised Anxiety Disorder scale (GAD-7)) outcomes. Post-treatment symptoms and effect sizes (d) were estimated for individuals with and without long-term conditions, controlling for covariates. The likelihood of access and response to intensive psychological interventions was also examined.RESULTS: Higher post-treatment symptoms were predicted for patients with musculoskeletal problems (d = 0.22-0.27), chronic obstructive pulmonary disease (d = 0.26-0.33), diabetes (d = 0.05-0.13) and psychotic disorders (d = 0.50-0.58). Most long-term conditions were associated with greater odds of accessing high-intensity therapies, yet individuals who accessed these continued to have higher average post-treatment symptoms.CONCLUSIONS: Some long-term conditions are associated with greater intensity of care and poorer outcomes after therapy.",

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AU - Gilbody, Simon Martin

AU - Boehnke, Jan Rasmus

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N2 - BACKGROUND: Long-term conditions often coexist with depression and anxiety.AIMS: To assess the effectiveness of stepped-care psychological therapies for patients with long-term conditions.METHOD: Data from 28 498 patients were analysed using regression to model depression (Patient Health Questionnaire (PHQ-9)) and anxiety (Generalised Anxiety Disorder scale (GAD-7)) outcomes. Post-treatment symptoms and effect sizes (d) were estimated for individuals with and without long-term conditions, controlling for covariates. The likelihood of access and response to intensive psychological interventions was also examined.RESULTS: Higher post-treatment symptoms were predicted for patients with musculoskeletal problems (d = 0.22-0.27), chronic obstructive pulmonary disease (d = 0.26-0.33), diabetes (d = 0.05-0.13) and psychotic disorders (d = 0.50-0.58). Most long-term conditions were associated with greater odds of accessing high-intensity therapies, yet individuals who accessed these continued to have higher average post-treatment symptoms.CONCLUSIONS: Some long-term conditions are associated with greater intensity of care and poorer outcomes after therapy.

AB - BACKGROUND: Long-term conditions often coexist with depression and anxiety.AIMS: To assess the effectiveness of stepped-care psychological therapies for patients with long-term conditions.METHOD: Data from 28 498 patients were analysed using regression to model depression (Patient Health Questionnaire (PHQ-9)) and anxiety (Generalised Anxiety Disorder scale (GAD-7)) outcomes. Post-treatment symptoms and effect sizes (d) were estimated for individuals with and without long-term conditions, controlling for covariates. The likelihood of access and response to intensive psychological interventions was also examined.RESULTS: Higher post-treatment symptoms were predicted for patients with musculoskeletal problems (d = 0.22-0.27), chronic obstructive pulmonary disease (d = 0.26-0.33), diabetes (d = 0.05-0.13) and psychotic disorders (d = 0.50-0.58). Most long-term conditions were associated with greater odds of accessing high-intensity therapies, yet individuals who accessed these continued to have higher average post-treatment symptoms.CONCLUSIONS: Some long-term conditions are associated with greater intensity of care and poorer outcomes after therapy.

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