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Trajectories of depression and anxiety symptom severity during psychological therapy for common mental health problems.
Skelton, Megan; Carr, Ewan; Buckman, Joshua E J; Davies, Molly R; Goldsmith, Kimberley A; Hirsch, Colette R; Peel, Alicia J; Rayner, Christopher; Rimes, Katharine A; Saunders, Rob; Wingrove, Janet; Breen, Gerome; Eley, Thalia C.
Afiliación
  • Skelton M; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Carr E; National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.
  • Buckman JEJ; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Davies MR; Research Department of Clinical, Centre for Outcomes Research and Effectiveness (CORE), Educational and Health Psychology, University College London, London, UK.
  • Goldsmith KA; iCope - Camden and Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK.
  • Hirsch CR; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Peel AJ; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Rayner C; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Rimes KA; South London and Maudsley NHS Foundation Trust, London, UK.
  • Saunders R; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Wingrove J; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Breen G; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Eley TC; Research Department of Clinical, Centre for Outcomes Research and Effectiveness (CORE), Educational and Health Psychology, University College London, London, UK.
Psychol Med ; 53(13): 6183-6193, 2023 10.
Article en En | MEDLINE | ID: mdl-36510471
BACKGROUND: There is substantial variation in patient symptoms following psychological therapy for depression and anxiety. However, reliance on endpoint outcomes ignores additional interindividual variation during therapy. Knowing a patient's likely symptom trajectories could guide clinical decisions. We aimed to identify latent classes of patients with similar symptom trajectories over the course of psychological therapy and explore associations between baseline variables and trajectory class. METHODS: Patients received high-intensity psychological treatment for common mental health problems at National Health Service Improving Access to Psychological Therapies services in South London (N = 16 258). To identify trajectories, we performed growth mixture modelling of depression and anxiety symptoms over 11 sessions. We then ran multinomial regressions to identify baseline variables associated with trajectory class membership. RESULTS: Trajectories of depression and anxiety symptoms were highly similar and best modelled by four classes. Three classes started with moderate-severe symptoms and showed (1) no change, (2) gradual improvement, and (3) fast improvement. A final class (4) showed initially mild symptoms and minimal improvement. Within the moderate-severe baseline symptom classes, patients in the two showing improvement as opposed to no change tended not to be prescribed psychotropic medication or report a disability and were in employment. Patients showing fast improvement additionally reported lower baseline functional impairment on average. CONCLUSIONS: Multiple trajectory classes of depression and anxiety symptoms were associated with baseline characteristics. Identifying the most likely trajectory for a patient at the start of treatment could inform decisions about the suitability and continuation of therapy, ultimately improving patient outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Salud Mental / Depresión Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Psychol Med Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Salud Mental / Depresión Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Psychol Med Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido