Effectiveness of primary care psychological therapy services for the treatment of depression and anxiety in people living with dementia: Evidence from national healthcare records in England

Predictors of primary care psychological therapy outcomes for depression and anxiety in people living with dementia: evidence from national healthcare records in England

“…Additionally, as in our previous research, the proportion of PLWD attending NHS TTad is likely much lower than the need for these services in this population. 7 Thus, our findings should be interpreted in the context of this selective sample. Other limitations of this research include that we could not account for any adaptations that may have been made during therapy for PLWD or for the degree of severity of dementia, as these data were not available.…”

“…The utility of this has been supported in large secondary data effectiveness studies with national coverage. 7 This research found large effect sizes for pre–post NHS TTad therapy improvement in symptoms of anxiety and depression in PLWD, although PLWD were less likely to reliably improve or reliably recover following psychological therapy than people without dementia. 7 Despite promising evidence for the effectiveness of primary care psychological therapy services for PLWD, there is significant variability in therapy outcomes within a dementia population, and little is known about why this might be.…”

“…With our previous findings suggesting that therapies offered in primary care psychological therapy services can be beneficial for reducing symptoms of depression and anxiety in PLWD, 7 understanding which PLWD may benefit is particularly valuable. One possible explanation for the preliminary finding that frontotemporal dementia is associated with greater reliable deterioration than Alzheimer's dementia and vascular dementia, is that people with frontotemporal dementia experience faster rates of decline in cognition and general functioning compared with people with other types of dementia; 33 therefore, this finding may be a reflection of general deterioration beyond symptoms of depression and anxiety.…”

“…This study uses the Mental health and other psychological therapy Outcomes; their relationship to Dementia Incidence in the Following Years (MODIFY) project dataset, 7 which includes NHS TTad data 20 linked with Hospital Episode Statistics (HES) data, 21 the Mental Health Services Dataset (MHSDS) 22 and HES-Office for National Statistics mortality data. 23 Anonymised data and linkage key were provided by NHS Digital.…”

“…Exclusion criteria were consistent with previous research using NHS TTad data. 7,13 Where participants entered treatment on more than one occasion during this period, only data from their first NHS TTad treatment episode were used. Participants were included if they received a course of psychological therapy (defined as at least two sessions), 20 had an ICD-10 matched problem descriptor (the term used to describe NHS TTad treatment focus) for an anxiety or depression diagnosis, 24 were not still receiving treatment, had complete pre-post data for the Patient Health Questionnaire-9 (PHQ-9) 25 and the Generalised Anxiety Disorder-7 screener (GAD-7), 26 and met clinical cut-off scores for depression (≥10 on the PHQ-9) or anxiety (≥8 on the GAD-7, or scoring above 'caseness' on any other anxiety disorder-specific measure (ADSM) matching the problem descriptor).…”