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

Jaime Delgadillo (Lead / Corresponding author), Alexander Dawson, Simon Martin Gilbody, Jan R. Böhnke

    Research output: Contribution to journalArticle

    7 Citations (Scopus)

    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 languageEnglish
    Pages (from-to)47-53
    Number of pages7
    JournalBritish Journal of Psychiatry
    Volume209
    Issue number5
    DOIs
    Publication statusPublished - 1 Nov 2016

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