Stepped care for the treatment of depression: a systematic review and meta-analysis

BackgroundIn stepped care models patients typically start with a low-intensity evidence-based treatment. Progress is monitored systematically and those patients who do not respond adequately step up to a subsequent treatment of higher intensity. Despite the fact that many guidelines have endorsed this stepped care principle it is not clear if stepped care really delivers similar or better patient outcomes against lower costs compared with other systems. We performed a systematic review and meta-analysis of all randomized trials on stepped care for depression.MethodWe carried out a comprehensive literature search. Selection of studies, evaluation of study quality and extraction of data were performed independently by two authors.ResultsA total of 14 studies were included and 10 were used in the meta-analyses (4580 patients). All studies used screening to identify possible patients and care as usual as a comparator. Study quality was relatively high. Stepped care had a moderate effect on depression (pooled 6-month between-group effect size Cohen'sdwas 0.34; 95% confidence interval 0.20–0.48). The stepped care interventions varied greatly in number and duration of treatment steps, treatments offered, professionals involved, and criteria to step up.ConclusionsThere is currently only limited evidence to suggest that stepped care should be the dominant model of treatment organization. Evidence on (cost-) effectiveness compared with high-intensity psychological therapy alone, as well as with matched care, is required.

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Depression and risk of disability pension: A systematic review and meta-analysis

The International Journal of Psychiatry in Medicine ◽

10.1177/0091217419837412 ◽

2019 ◽

pp. 009121741983741 ◽

Cited By ~ 4

Author(s):

Sohrab Amiri ◽

Sepideh Behnezhad

Keyword(s):

Systematic Review ◽

Confidence Interval ◽

Publication Bias ◽

Risk Ratio ◽

Disability Pension ◽

Common Mental Disorder ◽

Meta Analysis ◽

Psychological Consequences ◽

Treatment Of Depression

Background and objective Depression is a common mental disorder that leads to undesirable consequences. The study of the role of depression in disability pension can provide valuable insights. This study was conducted with the goal of systematic review and meta-analysis of the relationship between depression and disability pension. Methods PubMed, Scopus, PsycInfo, and Google Scholar databases were systematically searched until March 2018. Fifteen prospective cohort studies were selected and included in the meta-analysis. The random-effects method was used to combine the studies. Subgroup analysis was performed, and publication bias was also examined. Results Depression was a risk factor for disability pension (pooled risk ratio =1.68 and 95% confidence interval = 1.50–1.88). In men, pooled risk ratio was 1.82 for the effect of depression on the risk of disability pension (95% confidence interval = 1.45–2.28). In women, pooled risk ratio was 1.62 (95% confidence interval = 1.31–2.02). The results showed that there is publication bias. Conclusions Depression is a factor for retirement due to disability. Therefore, the prevention and treatment of depression can reduce socioeconomic and psychological consequences imposed on society.

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Psychological interventions for the treatment of depression, anxiety, alcohol misuse or anger in armed forces veterans and their families: systematic review and meta-analysis protocol

Systematic Reviews ◽

10.1186/s13643-017-0513-8 ◽

2017 ◽

Vol 6 (1) ◽

Cited By ~ 2

Author(s):

Luke O’Shea ◽

Ed Watkins ◽

Paul Farrand

Keyword(s):

Systematic Review ◽

Alcohol Misuse ◽

Meta Analysis ◽

Armed Forces ◽

Psychological Interventions ◽

Treatment Of Depression ◽

Analysis Protocol

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Three Decades of Internet- and Computer-Based Interventions for the Treatment of Depression: Protocol for a Systematic Review and Meta-Analysis

JMIR Research Protocols ◽

10.2196/14860 ◽

2020 ◽

Vol 9 (3) ◽

pp. e14860 ◽

Cited By ~ 1

Author(s):

Isaac Moshe ◽

Yannik Terhorst ◽

Pim Cuijpers ◽

Ioana Cristea ◽

Laura Pulkki-Råback ◽

...

Keyword(s):

Systematic Review ◽

Effect Size ◽

Meta Analysis ◽

Large Body ◽

Controlled Trials ◽

Cochrane Central Register ◽

Temporal Dimension ◽

The Past ◽

Treatment Of Depression ◽

Computer Based

Background Depression is one of the leading causes of disability worldwide. Internet- and computer-based interventions (IBIs) have been shown to provide effective, scalable forms of treatment. More than 100 controlled trials and a growing number of meta-analyses published over the past 30 years have demonstrated the efficacy of IBIs in reducing symptoms in the short and long term. Despite the large body of research, no comprehensive review or meta-analysis has been conducted to date that evaluates how the effectiveness of IBIs has evolved over time. Objective This systematic review and meta-analysis aims to evaluate whether there has been a change in the effectiveness of IBIs on the treatment of depression over the past 30 years and to identify potential variables moderating the effect size. Methods A sensitive search strategy will be executed across the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and PsycINFO. Data extraction and evaluation will be conducted by two independent researchers. Risk of bias will be assessed. A multilevel meta-regression model will be used to analyze the data and estimate effect size. Results The search was completed in mid-2019. We expect the results to be submitted for publication in early 2020. Conclusions The year 2020 will mark 30 years since the first paper was published on the use of IBIs for the treatment of depression. Despite the large and rapidly growing body of research in the field, evaluations of effectiveness to date are missing the temporal dimension. This review will address that gap and provide valuable analysis of how the effectiveness of interventions has evolved over the past three decades; which participant-, intervention-, and study-related variables moderate changes in effectiveness; and where research in the field may benefit from increased focus. Trial Registration PROSPERO CRD42019136554; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=136554 International Registered Report Identifier (IRRID) PRR1-10.2196/14860

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What Is the Recommended Dose of Physical Activity in the Treatment of Depression in Adults? A Protocol for a Systematic Review

Sustainability ◽

10.3390/su12145726 ◽

2020 ◽

Vol 12 (14) ◽

pp. 5726

Author(s):

Érica M. Correia ◽

Teresa Bento ◽

Filipe Rodrigues ◽

Luís Cid ◽

Anabela Vitorino ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Systematic Reviews ◽

Meta Analysis ◽

Recommended Dose ◽

Health Consequences ◽

Treatment Of Depression ◽

Prevalence Of Depression ◽

Important Health ◽

Beneficial Impact

The accurate measurement of physical activity (PA) in adults with depression is critical to identify important health consequences and determinants of this behavior. This study aimed to propose a protocol for a systematic review investigating the recommended dose of PA in the treatment of depression in adults aged 18 to 65 years. Additionally, we intend to examine the effect of PA interventions on the prevalence of depression. This protocol for a systematic review has been submitted in the Prospective International Register submitted in Register of Systematic Reviews of PROSPERO and is being prepared in accordance with the Declaration of Preferential Items for Systematic Reviews and Meta-Analysis Protocols. This protocol provides justification and planned methods for a systematic review to examine the respective dose of PA and how interventions have a beneficial impact on adults with depression.

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Risk of Depression and Suicidality among Diabetic Patients: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm7110445 ◽

2018 ◽

Vol 7 (11) ◽

pp. 445 ◽

Cited By ~ 6

Author(s):

Rasha Elamoshy ◽

Yelena Bird ◽

Lilian Thorpe ◽

John Moraros

Keyword(s):

Systematic Review ◽

Diabetes Management ◽

Meta Analysis ◽

Cochrane Library ◽

Diabetic Patients ◽

Cross Sectional ◽

Healthcare Settings ◽

Completed Suicide ◽

Treatment Of Depression ◽

Increased Risk

The purpose of this study is to conduct a systematic review and meta-analysis to evaluate the risk of depression and suicidality among diabetic patients. Methods: Medline, PubMed, EMBASE, Cochrane library, and Psych INFO were searched for studies published from 2008 onwards. Meta-analysis was conducted to estimate the pooled effect size. Sources of heterogeneity were investigated by subgroup analysis and meta-regression. Results: In total, 5750 articles were identified and of those, 17 studies on suicidality and 36 on depression were included in this study. Our analysis suggests a positive relationship between diabetes and depression (cohort studies odds ratio (OR) 1.49, 95% confidence interval (CI): 1.36–1.64 and cross-sectional studies OR 2.04, 95% CI, 1.73–2.42). Pooled OR values for suicidal ideation, attempted suicide, and completed suicide were 1.89 (95% CI: 1.36–2.63), 1.45 (95% CI: 1.07–1.96), and 1.85 (95% CI: 0.97–3.52), respectively. All findings were statistically significant except for completed suicide. Conclusions: The increased risk of depression and suicidality in diabetic patients highlights the importance of integrating the evaluation and treatment of depression with diabetes management in primary healthcare settings. Further research in this area is needed.

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