Counseling in Primary Care Improves Depression and Quality of Life

Carta, Mauro Giovanni; Петретто, Донателла Рита; Adamo, S.; Bhat, Krishna Moorthi; Lecca, Maria Efisia; Mura, Gioia; Carta, Valeria; Angermeyer, Matthias C.; Moro, Maria Francesca

doi:10.2174/1745017901208010152

Cited by 9 publications

(3 citation statements)

References 33 publications

(38 reference statements)

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“…In three RCTs, two of which were clustered RCTs, researchers investigated CBT‐based therapies in comparison to an active control (Carta et al., ; Moorey, Greer, Bliss, & Law, ; Van Der Klink, Blonk, Schene, & Van Dijk, ). Two studies were randomized at the healthcare provider level, which encompassed general practitioners (GPs) in one study (Carta et al., ) and occupational physicians in the other (Van Der Klink et al., ). In a clustered RCT of 64 rural Italian patients attending their GPs, 30 patients received GP‐only care and 34 received GP care plus psychologist‐delivered CBT based on a manual for depression treatment for a period of 6 months (Carta et al., ).…”

Section: Resultsmentioning

confidence: 99%

“…Two studies were randomized at the healthcare provider level, which encompassed general practitioners (GPs) in one study (Carta et al., ) and occupational physicians in the other (Van Der Klink et al., ). In a clustered RCT of 64 rural Italian patients attending their GPs, 30 patients received GP‐only care and 34 received GP care plus psychologist‐delivered CBT based on a manual for depression treatment for a period of 6 months (Carta et al., ). At baseline, 59% of the sample had been diagnosed with adjustment disorder according to DSM‐IV .…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review of Psychological and Pharmacological Treatments for Adjustment Disorder in Adults

O’Donnell

Metcalf

Watson

et al. 2018

Journal of Traumatic Stress

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Adjustment disorder is a common psychiatric disorder, yet knowledge of the efficacious treatments for adjustment disorder is limited. In this systematic review, we aimed to examine psychological and pharmacological interventions that target adjustment disorder in adults to determine which interventions have the best evidence for improving adjustment disorder symptoms. We performed database searches for literature published between January 1980 and September 2016 and identified studies that included both a sample majority of individuals diagnosed with adjustment disorder and findings on adjustment disorder symptom outcomes. There were 29 studies that met the inclusion criteria for qualitative synthesis; the majority of studies (59%) investigated psychological therapies rather than pharmacological treatments (35%). The range of psychological therapies tested was diverse, with the majority containing cognitive behavioral therapy (CBT) components (53%), followed by three studies that were psychodynamic-related, three studies that were behavioral therapy-based, and two studies that involved relaxation techniques. We rated individual studies using a modified National Health and Medical Research Council quality and bias checklist and then used the Grading of Recommendations Assessment, Development and Evaluation (GRADE; Grade Working Group, 2004) system to rate the overall quality of the evidence. Despite several randomized controlled trials, the quality of the evidence for positive effects of all psychological and pharmacological treatments on symptoms of adjustment disorder was ranked as low to very low. Future high-quality research in the treatment of adjustment disorder has the potential to make a significant difference to individuals who struggle to recover after stressful events.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Psychological and Pharmacological Treatments for Adjustment Disorder in Adults

O’Donnell

Metcalf

Watson

et al. 2018

Journal of Traumatic Stress

View full text Add to dashboard Cite

show abstract

“…During 10 months, the participants benefited both from individual counseling (roughly one meeting every two weeks) and from small-group counseling (once a month on average) both according to the Behavioral - Cognitive Therapy approach [35]. The counseling specifically analyzed feelings and thoughts related to the difficulty of learning, any feelings of aggression toward peers and teachers and tried to show whether these arose in relation to certain conditions (i.e.…”

Section: Methodsmentioning

confidence: 99%

Could an Innovative Training Program Including Contact Sports and Counseling Help Young People With Traits of Psychopathy and A History of School Dropout?

Sancassiani¹,

Lecca²,

Pintus³

et al. 2019

CPEMH

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Background: The aim was to assess the effects of a training program inclusive of contact sports and counseling on school dropout, quality of life (QoL) and psychopathologic symptoms in the youth with a history of school dropout and psychopathic personality traits. Methods: The Experimental Group (EG) consisted of 32 subjects (male 90.6%; age 19.6±4.3 years); the Control Group (CG) consisted of an equal number matched for gender and age with the same psychological features. At the beginning of the experimental Training Program (T0), both cohorts were assessed by a diagnostic psychiatric interview (SCID ANTAS), the Short Form Health Survey (SF-12) to evaluate QoL, the Psychopathy Checklist - Revised (PCL-R) for the assessment of psychopathic traits, the Self Reporting Questionnaire (SRQ) to measure general psychopathology. At the end of the program (T1), the coorths were evaluated by SF-12 and SRQ. Results: Twenty-seven subjects in the EG (84.4%) completed the course and underwent the evaluation at T1. The SF-12 score significantly increased from T0 to T1 in both groups, albeit this was more evident in the EG than in the CG, owing to an interaction between time and group. SRQ score significantly decreased in the EG from T0 to T1, while in the CG it did not, although the interaction between time and group was not significant. Conclusion: The experimental training program was effective in improving QoL and countering school dropout in young citizens with psychopathic traits. Further studies are needed to clarify if such results are due to a relationship between the practical tasks approach including contact sports and an improvement in mentalization processes.

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A comparison of the effectiveness of cognitive behavioural interventions based on delivery features for elevated symptoms of depression in adolescents: A systematic review

Bjornstad,

Sonthalia,

Rouse

et al. 2024

Campbell Systematic Reviews

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BackgroundDepression is a public health problem and common amongst adolescents. Cognitive behavioural therapy (CBT) is widely used to treat adolescent depression but existing research does not provide clear conclusions regarding the relative effectiveness of different delivery modalities.ObjectivesThe primary aim is to estimate the relative efficacy of different modes of CBT delivery compared with each other and control conditions for reducing depressive symptoms in adolescents. The secondary aim is to compare the different modes of delivery with regard to intervention completion/attrition (a proxy for intervention acceptability).Search MethodsThe Cochrane Depression, Anxiety and Neurosis Clinical Trials Register was searched in April 2020. MEDLINE, PsycInfo, EMBASE, four other electronic databases, the CENTRAL trial registry, Google Scholar and Google were searched in November 2020, together with reference checking, citation searching and hand‐searching of two databases.Selection CriteriaRandomised controlled trials (RCTs) of CBT interventions (irrespective of delivery mode) to reduce symptoms of depression in young people aged 10–19 years with clinically relevant symptoms or diagnosis of depression were included.Data Collection and AnalysisScreening and data extraction were completed by two authors independently, with discrepancies addressed by a third author. CBT interventions were categorised as follows: group CBT, individual CBT, remote CBT, guided self‐help, and unguided self‐help. Effect on depressive symptom score was estimated across validated self‐report measures using Hedges' g standardised mean difference. Acceptability was estimated based on loss to follow‐up as an odds ratio. Treatment rankings were developed using the surface under the cumulative ranking curve (SUCRA). Pairwise meta‐analyses were conducted using random effects models where there were two or more head‐to‐head trials. Network analyses were conducted using random effects models.Main ResultsSixty‐eight studies were included in the review. The mean age of participants ranged from 10 to 19.5 years, and on average 60% of participants were female. The majority of studies were conducted in schools (28) or universities (6); other settings included primary care, clinical settings and the home. The number of CBT sessions ranged from 1 to 16, the frequency of delivery from once every 2 weeks to twice a week and the duration of each session from 20 min to 2 h. The risk of bias was low across all domains for 23 studies, 24 studies had some concerns and the remaining 21 were assessed to be at high risk of bias. Sixty‐two RCTs (representing 6435 participants) were included in the pairwise and network meta‐analyses for post‐intervention depressive symptom score at post‐intervention. All pre‐specified treatment and control categories were represented by at least one RCT. Although most CBT approaches, except remote CBT, demonstrated superiority over no intervention, no approaches performed clearly better than or equivalent to another. The highest and lowest ranking interventions were guided self‐help (SUCRA 83%) and unguided self‐help (SUCRA 51%), respectively (very low certainty in treatment ranking). Nineteen RCTs (3260 participants) were included in the pairwise and network meta‐analyses for 6 to 12 month follow‐up depressive symptom score. Neither guided self‐help nor remote CBT were evaluated in the RCTs for this time point. Effects were generally attenuated for 6‐ to 12‐month outcomes compared to posttest. No interventions demonstrated superiority to no intervention, although unguided self‐help and group CBT both demonstrated superiority compared to TAU. No CBT approach demonstrated clear superiority over another. The highest and lowest ranking approaches were unguided self‐help and individual CBT, respectively. Sixty‐two RCTs (7347 participants) were included in the pairwise and network meta‐analyses for intervention acceptability. All pre‐specified treatment and control categories were represented by at least one RCT. Although point estimates tended to favour no intervention, no active treatments were clearly inferior. No CBT approach demonstrated clear superiority over another. The highest and lowest ranking active interventions were individual CBT and group CBT respectively. Pairwise meta‐analytic findings were similar to those of the network meta‐analysis for all analyses. There may be age‐based subgroup effects on post‐intervention depressive symptoms. Using the no intervention control group as the reference, the magnitudes of effects appear to be larger for the oldest age categories compared to the other subgroups for each given comparison. However, they were generally less precise and formal testing only indicated a significant difference for group CBT. Findings were robust to pre‐specified sensitivity analyses separating out the type of placebo and excluding cluster‐RCTs, as well as an additional analysis excluding studies where we had imputed standard deviations.Authors' ConclusionsAt posttreatment, all active treatments (group CBT, individual CBT, guided self‐help, and unguided self‐help) except for remote CBT were more effective than no treatment. Guided self‐help was the most highly ranked intervention but only evaluated in trials with the oldest adolescents (16–19 years). Moreover, the studies of guided self‐help vary in the type and amount of therapist support provided and longer‐term results are needed to determine whether effects persist. The magnitude of effects was generally attenuated for 6‐ to 12‐month outcomes. Although unguided self‐help was the lowest‐ranked active intervention at post‐intervention, it was the highest ranked at follow‐up. This suggests the need for further research into whether interventions with self‐directed elements enable young people to maintain effects by continuing or revisiting the intervention independently, and whether therapist support would improve long‐term outcomes. There was no clear evidence that any active treatments were more acceptable to participants than any others. The relative effectiveness of intervention delivery modes must be taken into account in the context of the needs and preferences of individual young people, particularly as the differences between effect sizes were relatively small. Further research into the type and amount of therapist support that is most acceptable to young people and most cost‐effective would be particularly useful.

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Counseling in Primary Care Improves Depression and Quality of Life

Cited by 9 publications

References 33 publications

A Systematic Review of Psychological and Pharmacological Treatments for Adjustment Disorder in Adults

A Systematic Review of Psychological and Pharmacological Treatments for Adjustment Disorder in Adults

Could an Innovative Training Program Including Contact Sports and Counseling Help Young People With Traits of Psychopathy and A History of School Dropout?

A comparison of the effectiveness of cognitive behavioural interventions based on delivery features for elevated symptoms of depression in adolescents: A systematic review

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