Acceptability of a Clinician-Assisted Computerized Psychological Intervention for Comorbid Mental Health and Substance Use Problems: Treatment Adherence Data from a Randomized Controlled Trial

Abstract Background In many low resource settings, the provision of government mental health care services is limited to specialized psychiatry units in urban hospital care facilities, where the most common treatment for common mental disorders (CMDs) is pharmacotherapy, occasionally with adjunct nonspecific psychological support. We aimed to evaluate the effectiveness of adding a low intensity, psychological intervention, Problem Management Plus (PM+) for CMDs into routine care in a specialized mental health care facility in Pakistan. Methods A two arm, single-blind individual randomized controlled trial (RCT) was carried out with adults (N=192), referred for psychological support by psychiatrists. The study participants were randomized (1:1) to PM+ plus Treatment as Usual (TAU) (n = 96) or TAU only (n = 96). The primary outcomes were symptoms of anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS) and functional impairment as measured by WHO Disability Assessment Schedule (WHODAS-12) at 20-weeks after baseline. Results The analysis was done on intention-to-treat principle. The linear mixed model analysis showed that at 20-weeks after baseline, there was a significant reduction in symptoms of anxiety and depression (mean [SD], 16.23 [8.81] vs 19.79 [7.77]; AMD, -3.10; 95% CI, −0.26 to −5.76); p =0.03 and improvement in functioning (mean [SD], 22.94 [9.37] vs 27.37 [8.36]; AMD, -4.35; 95% CI, -1.45 to -7.24); p =0.004 in PM+ plus TAU versus TAU group. The follow-up rate was 67% at primary end-point. Conclusions Specialized care facilities in LMICs may consider adding brief, evidence-based psychological treatments for CMDs to their routine care.

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Interactive Voice Response with Feedback Intervention in Outpatient Treatment of Substance Use Problems in Adolescents and Young Adults: A Randomized Controlled Trial

International Journal of Behavioral Medicine ◽

10.1007/s12529-016-9625-0 ◽

2016 ◽

Vol 24 (5) ◽

pp. 789-797 ◽

Cited By ~ 6

Author(s):

Claes Andersson ◽

Agneta Öjehagen ◽

Martin O Olsson ◽

Louise Brådvik ◽

Anders Håkansson

Keyword(s):

Randomized Controlled Trial ◽

Substance Use ◽

Young Adults ◽

Outpatient Treatment ◽

Interactive Voice Response ◽

Controlled Trial ◽

Adolescents And Young Adults ◽

Feedback Intervention ◽

Randomized Controlled ◽

Substance Use Problems

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Effect of adding a psychological intervention to routine care of common mental disorders in a specialized mental healthcare facility in Pakistan: a randomized controlled trial

International Journal of Mental Health Systems ◽

10.1186/s13033-020-00434-y ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Syed Usman Hamdani ◽

Zill-e- Huma ◽

Aqsa Masood ◽

Kaina Zhou ◽

Zainab Ahmed ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Randomized Controlled Trial ◽

Common Mental Disorders ◽

Psychological Intervention ◽

Controlled Trial ◽

Routine Care ◽

Anxiety And Depression ◽

Randomized Controlled ◽

Care Facilities

Abstract Background In many low resource settings, the provision of government mental health care services is limited to specialized psychiatry units in urban hospital care facilities, where the most common treatment for common mental disorders (CMDs) is pharmacotherapy, occasionally with adjunct nonspecific psychological support. We aimed to evaluate the effectiveness of adding a low intensity, psychological intervention, Problem Management Plus (PM+) for CMDs into routine care in a specialized mental health care facility in Pakistan. Methods A two arm, single-blind individual randomized controlled trial (RCT) was carried out with adults (N = 192), referred for psychological support by psychiatrists. The study participants were randomized (1:1) to PM + plus Treatment as Usual (TAU) (n = 96) or TAU only (n = 96). The primary outcomes were symptoms of anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS) and functional impairment as measured by WHO Disability Assessment Schedule (WHODAS 2.0) at 20 weeks after baseline. Results The analysis was done on intention-to-treat principle. The linear mixed model analysis showed that at 20 weeks after baseline, there was a significant reduction in symptoms of anxiety and depression (mean [SD], 16.23 [8.81] vs 19.79 [7.77]; AMD, − 3.10; 95% CI, − 0.26 to − 5.76); p = 0.03 and improvement in functioning (mean [SD], 22.94 [9.37] vs 27.37 [8.36]; AMD, − 4.35; 95% CI, − 1.45 to − 7.24); p = 0.004 in PM + plus TAU versus TAU arm. The follow-up rate was 67% at primary end-point. Conclusions Specialized care facilities in LMICs may consider adding brief, evidence-based psychological treatments for CMDs to their routine care. Trial Registration Australian New Zealand Clinical Trials Registry, ACTRN12616000381482. Registered March 23, 2016. Retrospectively registered, https://www.anzctr.org.au/Default.aspx/ ACTRN12616000381482

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Effect of adding a psychological intervention to routine care of common mental disorders in a specialized mental healthcare facility in Pakistan: a randomized controlled trial

10.21203/rs.3.rs-26484/v2 ◽

2020 ◽

Author(s):

Syed Usman Hamdani ◽

Zill-e- Huma ◽

Aqsa Masood ◽

Kiana Zhou ◽

Zainab Ahmed ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Randomized Controlled Trial ◽

Common Mental Disorders ◽

Psychological Intervention ◽

Controlled Trial ◽

Routine Care ◽

Anxiety And Depression ◽

Randomized Controlled ◽

Care Facilities

Abstract Background: In many low resource settings, the provision of government mental health care services is limited to specialized psychiatry units in urban hospital care facilities, where the most common treatment for common mental disorders (CMDs) is pharmacotherapy, occasionally with adjunct nonspecific psychological support. We aimed to evaluate the effectiveness of adding a low intensity, psychological intervention, Problem Management Plus (PM+) for CMDs into routine care in a specialized mental health care facility in Pakistan.Methods: A two arm, single-blind individual randomized controlled trial (RCT) was carried out with adults (N=192), referred for psychological support by psychiatrists. The study participants were randomized (1:1) to PM+ plus Treatment as Usual (TAU) (n = 96) or TAU only (n = 96). The primary outcomes were symptoms of anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS) and functional impairment as measured by WHO Disability Assessment Schedule (WHODAS 2.0) at 20 weeks after baseline.Results: The analysis was done on intention-to-treat principle. The linear mixed model analysis showed that at 20 weeks after baseline, there was a significant reduction in symptoms of anxiety and depression (mean [SD], 16.23 [8.81] vs 19.79 [7.77]; AMD, -3.10; 95% CI, −0.26 to −5.76); p=0.03 and improvement in functioning (mean [SD], 22.94 [9.37] vs 27.37 [8.36]; AMD, -4.35; 95% CI, -1.45 to -7.24); p=0.004 in PM+ plus TAU versus TAU arm . The follow-up rate was 67% at primary end-point.Conclusions: Specialized care facilities in LMICs may consider adding brief, evidence-based psychological treatments for CMDs to their routine care.Trial Registration: Australian New Zealand Clinical Trials Registry, ACTRN12616000381482. Registered March 23, 2016- Retrospectively registered, https://www.anzctr.org.au/Default.aspx/ ACTRN12616000381482

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Effect of adding a psychological intervention to routine care of common mental disorders in a specialized mental healthcare facility in Pakistan: a randomized controlled trial

10.21203/rs.3.rs-26484/v3 ◽

2021 ◽

Author(s):

Syed Usman Hamdani ◽

Zill-e- Huma ◽

Aqsa Masood ◽

Kiana Zhou ◽

Zainab Ahmed ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Randomized Controlled Trial ◽

Common Mental Disorders ◽

Psychological Intervention ◽

Controlled Trial ◽

Routine Care ◽

Anxiety And Depression ◽

Randomized Controlled ◽

Care Facilities

Abstract Background: In many low resource settings, the provision of government mental health care services is limited to specialized psychiatry units in urban hospital care facilities, where the most common treatment for common mental disorders (CMDs) is pharmacotherapy, occasionally with adjunct nonspecific psychological support. We aimed to evaluate the effectiveness of adding a low intensity, psychological intervention, Problem Management Plus (PM+) for CMDs into routine care in a specialized mental health care facility in Pakistan. Methods: A two arm, single-blind individual randomized controlled trial (RCT) was carried out with adults (N=192), referred for psychological support by psychiatrists. The study participants were randomized (1:1) to PM+ plus Treatment as Usual (TAU) (n = 96) or TAU only (n = 96). The primary outcomes were symptoms of anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS) and functional impairment as measured by WHO Disability Assessment Schedule (WHODAS 2.0) at 20 weeks after baseline. Results: The analysis was done on intention-to-treat principle. The linear mixed model analysis showed that at 20 weeks after baseline, there was a significant reduction in symptoms of anxiety and depression (mean [SD], 16.23 [8.81] vs 19.79 [7.77]; AMD, -3.10; 95% CI, −0.26 to −5.76); p=0.03 and improvement in functioning (mean [SD], 22.94 [9.37] vs 27.37 [8.36]; AMD, -4.35; 95% CI, -1.45 to -7.24); p=0.004 in PM+ plus TAU versus TAU arm. The follow-up rate was 67% at primary end-point. Conclusions: Specialized care facilities in LMICs may consider adding brief, evidence-based psychological treatments for CMDs to their routine care.

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