Scaling up psychological treatments for common mental disorders: a call to action

Singla, Daisy R.; Raviola, Giuseppe; Patel, Vikram

doi:10.1002/wps.20532

Cited by 55 publications

(42 citation statements)

References 12 publications

(5 reference statements)

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“…However, they are rarely applied in ordinary conditions, because they typically involve many therapy sessions, require mental health specialists, and are predicated on a skilled diagnosis of PTSD. In response to this situation, there has been a concerted effort in recent years to engage in “task‐shifting”, which involves training non‐specialists to deliver evidence‐based programs to address a range of common mental disorders. This approach has been used successfully in treating PTSD.…”

Section: Major Challenges For the Ptsd Fieldmentioning

confidence: 99%

Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges

2019

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Post-traumatic stress disorder (PTSD) is arguably the most common psychiatric disorder to arise after exposure to a traumatic event. Since its formal introduction in the DSM-III in 1980, knowledge has grown significantly regarding its causes, maintaining mechanisms and treatments. Despite this increased understanding, however, the actual definition of the disorder remains controversial. The DSM-5 and ICD-11 define the disorder differently, reflecting disagreements in the field about whether the construct of PTSD should encompass a broad array of psychological manifestations that arise after trauma or should be focused more specifically on trauma memory phenomena. This controversy over clarifying the phenotype of PTSD has limited the capacity to identify biomarkers and specific mechanisms of traumatic stress. This review provides an up-to-date outline of the current definitions of PTSD, its known prevalence and risk factors, the main models to explain the disorder, and evidence-supported treatments. A major conclusion is that, although trauma-focused cognitive behavior therapy is the best-validated treatment for PTSD, it has stagnated over recent decades, and only two-thirds of PTSD patients respond adequately to this intervention. Moreover, most people with PTSD do not access evidence-based treatment, and this situation is much worse in low-and middle-income countries. Identifying processes that can overcome these major barriers to better management of people with PTSD remains an outstanding challenge.

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Section: Major Challenges For the Ptsd Fieldmentioning

confidence: 99%

Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges

2019

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“…Despite many advances in psychotherapies and pharmacological treatments for a range of psychiatric conditions, there remains a substantial proportion of individuals who do not achieve full remission from standard treatment 3,4 . Additionally, a large portion of the global population do not have access to traditional mental health care, due to the scarcity of psychiatric services available, particularly in many low-and middle-income countries 3,5 .…”

mentioning

confidence: 99%

A meta‐review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders

et al. 2020

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There is increasing academic and clinical interest in how “lifestyle factors” traditionally associated with physical health may also relate to mental health and psychological well‐being. In response, international and national health bodies are producing guidelines to address health behaviors in the prevention and treatment of mental illness. However, the current evidence for the causal role of lifestyle factors in the onset and prognosis of mental disorders is unclear. We performed a systematic meta‐review of the top‐tier evidence examining how physical activity, sleep, dietary patterns and tobacco smoking impact on the risk and treatment outcomes across a range of mental disorders. Results from 29 meta‐analyses of prospective/cohort studies, 12 Mendelian randomization studies, two meta‐reviews, and two meta‐analyses of randomized controlled trials were synthesized to generate overviews of the evidence for targeting each of the specific lifestyle factors in the prevention and treatment of depression, anxiety and stress‐related disorders, schizophrenia, bipolar disorder, and attention‐deficit/hyperactivity disorder. Standout findings include: a) convergent evidence indicating the use of physical activity in primary prevention and clinical treatment across a spectrum of mental disorders; b) emerging evidence implicating tobacco smoking as a causal factor in onset of both common and severe mental illness; c) the need to clearly establish causal relations between dietary patterns and risk of mental illness, and how diet should be best addressed within mental health care; and d) poor sleep as a risk factor for mental illness, although with further research required to understand the complex, bidirectional relations and the benefits of non‐pharmacological sleep‐focused interventions. The potentially shared neurobiological pathways between multiple lifestyle factors and mental health are discussed, along with directions for future research, and recommendations for the implementation of these findings at public health and clinical service levels.

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“…One unique exemplar of scaling up these treatments is the UK's Improving Access to Psychological Treatments (IAPT). IAPT services treat more than 537,000 patients with depression and anxiety annually, train non-specialist providers and specialists with brief accredited courses, and assess the progress of almost all (98%) patients using a unique monitoring outcome system 10 . Their results show that stepped care models of delivery are clinically effective, facilitate short wait times to improve patient attendance, and ultimately increase collaboration between therapists and patients.…”

mentioning

confidence: 99%

Progress in developing a classification of personality disorders for ICD‐11

Reed

2018

World Psychiatry

103

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Scaling up psychological treatments for common mental disorders: a call to action

Cited by 55 publications

References 12 publications

Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges

Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges

A meta‐review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders

Progress in developing a classification of personality disorders for ICD‐11

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