Patient Preference for Psychological vs Pharmacologic Treatment of Psychiatric Disorders

McHugh, R. Kathryn; Whitton, Sarah W.; Peckham, Andrew; Welge, Jeffrey A.; Otto, Michael W.

doi:10.4088/jcp.12r07757

Cited by 623 publications

(456 citation statements)

References 66 publications

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“…However, most people with a depressive disorder do not receive treatment, especially in lowand middle-income countries, where only between 7 and 21% of patients are treated 5 . If patients get treatment, this typically consists of pharmacotherapy, while the majority of patients prefer psychotherapies 9 .…”

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confidence: 99%

Psychotherapies for depression in low‐ and middle‐income countries: a meta‐analysis

et al. 2018

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Most psychotherapies for depression have been developed in high-income Western countries of North America, Europe and Australia. A growing number of randomized trials have examined the effects of these treatments in non-Western countries. We conducted a meta-analysis of these studies to examine whether these psychotherapies are effective and to compare their effects between studies from Western and nonWestern countries. We conducted systematic searches in bibliographical databases and included 253 randomized controlled trials, of which 32 were conducted in non-Western countries. The effects of psychotherapies in non-Western countries were large (g51.10; 95% CI: 0.91-1.30), with high heterogeneity (I 2 590; 95% CI: 87-92). After adjustment for publication bias, the effect size dropped to g50.73 (95% CI: 0.51-0.96). Subgroup analyses did not indicate that adaptation to the local situation was associated with the effect size. Comparisons with the studies in Western countries showed that the effects of the therapies were significantly larger in non-Western countries, also after adjusting for characteristics of the participants, the treatments and the studies. These larger effect sizes in non-Western countries may reflect true differences indicating that therapies are indeed more effective; or may be explained by the care-as-usual control conditions in non-Western countries, often indicating that no care was available; or may be the result of the relative low quality of many trials in the field. This study suggests that psychotherapies that were developed in Western countries may or may not be more effective in non-Western countries, but they are probably no less effective and can therefore also be used in these latter countries.

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confidence: 99%

Psychotherapies for depression in low‐ and middle‐income countries: a meta‐analysis

et al. 2018

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“…It is important to understand the current findings in combination with recent evidence from the USA of increased prescribing for bereaved parents following perinatal death (Lacasse & Cacciatore, 2014) and a recent review which indicated that antidepressants tend to improve the symptoms of depression more than symptoms of grief (Hensley, 2006). Furthermore, it is necessary that services consistently offer holistic approaches which include psychological components and facilitate client choice when considering interventions (McHugh, Whitton, Peckham, Welge, & Otto, 2013). Psychological professionals and healthcare staff with additional psychological training could utilize these findings to deliver staff training, promote user-led services or work with individuals in order to facilitate sense making and cognitive re-framing of experiences.…”

Section: Discussionmentioning

confidence: 99%

Understanding mothers’ experiences of positive changes after neonatal death

Waugh

Kiemle

Slade

2018

European Journal of Psychotraumatology

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Background: The death of a neonatal baby has the potential for parents to experience many negative outcomes. Post traumatic growth describes positive personal change from the struggle with a traumatic event. This has not been explored in this context.Objective: This study sought to understand the experiences of mothers whose neonatal baby had died; in particular, whether mothers were able to experience any positive changes in their lives since the death of their baby. The study also sought to explore what factors may have facilitated or prevented these changes.Method: Ten mothers were recruited, whose baby had died in the neonatal period between two and 10 years previously. Mothers completed semi-structured, one-to-one interviews. Interview transcripts were analysed using Template Analysis.Results: Despite ongoing sadness, mothers recognized positive personal changes in their self-perception, relationships and life philosophy which were consistent with the post-traumatic growth model. Mothers also identified facilitators and barriers to these changes which were categorized into five themes: ‘Person-centred care’, ‘making sense’, ‘personal coping strategies’, ‘learning to live with it’ and ‘identity’.Conclusions: This study identified that the mothers made a conscious personal decision to cope with their experience. This is a unique finding which requires further exploration. Facilitators and barriers of growth both occurred as elements within the same five themes, indicating that all identified domains before and after the death have the potential to facilitate or to prevent personal growth. Importantly, these findings indicate that person-centred services, which are responsive to individual needs at all stages, are vital when providing maternity care in the context of loss.

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“…Recent studies report drop-out rates ranging from 21.5-43% in detoxification [89,90] outpatient treatment 23-50% [91,92], inpatient treatment 17-57% [93] and substitution treatment 32-67.7% [94,95]. A meta-analysis of psychotherapy found a dropout rate between 19 and 47% [96].…”

Section: Positive Outcomesmentioning

confidence: 99%

Review on Treatment of Substance Use Disorders

Njoroge¹

2017

J Addict Res Ther

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Services for mental and substance use disorders have typically been neglected, and in many countries segregated from mainstream health care with resources allocated not commensurate with the burden. The attention given to mental and substance use disorders cannot be compared to other diseases such as HIV/AIDS, Malaria, Cancer, and Diabetes among others. Mental and substance use disorders account to about 7.4% of disease burden worldwide. These disorders are responsible for more of the global burden than HIV/AIDS and tuberculosis, diabetes, or transport injuries.The increasing number of cases of SUDs globally presents a public health challenge that requires effective evidence based interventions. One of the major challenges is inadequate treatment for SUDs which mostly plague developing countries. It may be difficult to measure the efficacy of treatment as a result of unique patient characteristics that contribute to person's treatment experience. Care factors such as duration of treatment and length of stay have been studied as having influence on the outcome of treatment. Others include patient and environmental factors.Globally, poor treatment outcomes mostly reported include dropout rates as high as 90%; relapse rates as high as 91% and high after treatment mortality rates. Research findings have identified many evidence-based treatment strategies for managing substance use disorders, nevertheless there is a gap that continues to exist, that of a lack of success of effective interventions to be spread and implemented so as to improve the lives of those affected. Other studies have also reported these differences in the outcomes and effectiveness of treatment of substance use disorders.There is need for enhanced interventional research that aims at providing an overview of conceptual issues relating to factors that influence treatment outcomes and identifying gaps and directions for improving treatment and treatment outcomes. The fundamental objective of enhanced research in substance use treatment is to reduce the increasing prevalence rates of substance use disorders.

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Patient Preference for Psychological vs Pharmacologic Treatment of Psychiatric Disorders

Cited by 623 publications

References 66 publications

Psychotherapies for depression in low‐ and middle‐income countries: a meta‐analysis

Psychotherapies for depression in low‐ and middle‐income countries: a meta‐analysis

Understanding mothers’ experiences of positive changes after neonatal death

Review on Treatment of Substance Use Disorders

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