A Comparative Effectiveness Trial of Depression Collaborative Care: Subanalysis of Comorbid Anxiety.
Kristen R Choi, Cathy Sherbourne, Lingqi Tang and 6 others
PMID 30226112WHAT IT FOUND
In adults with both depression and anxiety, a community-coalition approach improved mental wellness and quality of life at six months compared to standard technical assistance.
These benefits faded by twelve months, and depression scores did not significantly differ between the two groups.
Key findings
01At six months, participants with comorbid depression and anxiety in the community-coalition arm had lower odds of poor mental health-related quality of life, fewer risk factors for chronic homelessness, fewer behavioral health hospitalizations, and higher odds of endorsing mental wellness compared to the technical assistance arm.
02There were no significant differences between the two intervention arms for the primary depression outcome or anxiety scores at six months, and no significant differences for any outcome at twelve months.
03Participants with comorbid depression and anxiety had a higher burden of illness than those with depression only, including more chronic illnesses and substance use, and fewer participants endorsed mental wellness.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was not originally powered for this specific subgroup analysis, which limits the certainty of the findings. There was no usual care control group, so it is unclear if the improvements were due to the specific interventions or general effects of being in a study. All outcomes were based on client self-report, which is subject to bias. The effects did not sustain beyond six months, and the study was conducted in communities with existing experience in community-partnered research, which may not be replicable elsewhere.
Declared interests
The study was funded by the National Institute of Mental Health (NIMH) and the National Institute on Drug Abuse (NIDA). The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that this community-coalition approach is superior to standard technical assistance for treating depression or anxiety symptoms directly. The primary clinical outcomes (depression and anxiety scores) showed no significant difference between the groups, and the benefits observed were limited to broader wellness and social indicators at only six months.