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Impact of long-term medical conditions on the outcomes of psychological therapy for depression and anxiety

  • Jaime Delgadillo (a1), Alexander Dawson (a2), Simon Gilbody (a3) and Jan R. Böhnke (a3)
Abstract
Background

Long-term conditions often coexist with depression and anxiety.

Aims

To assess the effectiveness of stepped-care psychological therapies for patients with long-term conditions.

Method

Data from 28 498 patients were analysed using regression to model depression (Patient Health Questionnaire (PHQ-9)) and anxiety (Generalised Anxiety Disorder scale (GAD-7)) outcomes. Post-treatment symptoms and effect sizes (d) were estimated for individuals with and without long-term conditions, controlling for covariates. The likelihood of access and response to intensive psychological interventions was also examined.

Results

Higher post-treatment symptoms were predicted for patients with musculoskeletal problems (d = 0.22–0.27), chronic obstructive pulmonary disease (d = 0.26–0.33), diabetes (d = 0.05–0.13) and psychotic disorders (d = 0.50–0.58). Most long-term conditions were associated with greater odds of accessing high-intensity therapies, yet individuals who accessed these continued to have higher average post-treatment symptoms.

Conclusions

Some long-term conditions are associated with greater intensity of care and poorer outcomes after therapy.

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Copyright
Corresponding author
Jaime Delgadillo, Clinical Psychology Unit, Department of Psychology, University of Sheffield, Western Bank, Sheffield S10 2TN, UK. Email: jaime.delgadillo@nhs.net
Footnotes
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Declaration of interest

None.

Footnotes
References
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
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Impact of long-term medical conditions on the outcomes of psychological therapy for depression and anxiety

  • Jaime Delgadillo (a1), Alexander Dawson (a2), Simon Gilbody (a3) and Jan R. Böhnke (a3)
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