A systematic review and meta-analysis of transdiagnostic interventions for common mental disorders in primary care

IF 4.1 2区医学 Q1 PSYCHIATRY

General hospital psychiatry Pub Date : 2024-11-01 DOI:10.1016/j.genhosppsych.2024.11.003

Marie Vogel , Christopher Ebert , Jochen Gensichen , Hanna Applis , Alkomiet Hasan , Kirsten Lochbühler , POKAL-Group

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引用次数: 0

Abstract

Objective

In primary care, treating common mental disorders according to the ICD or DSM is challenging. A transdiagnostic approach may facilitate the management of mental health problems by treating across psychiatric diagnoses.

This meta-analysis aims to identify and compare transdiagnostic interventions delivered in primary care and to determine the effectiveness of these interventions, focusing on common mental disorders.

Methods

A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching the databases Medline, Embase, Web of Science, and PsycINFO. Standardized mean differences (SMD) were calculated for the outcomes, and additional subgroup analyses were performed.

Results

From an initial set of 10,618 RCTs, 38 studies were included and retained for data extraction. Transdiagnostic interventions led to a significant reduction in symptoms of depression (SMD: −0.38) and anxiety (SMD: - 0.47). Treatment outcomes for somatoform disorders were not significant (SMD: - 0.22). About half of the interventions were provided by health professionals not specifically trained in psychotherapy; these interventions also proved to be effective (depression: SMD: −0.47; anxiety: −0.39).

Conclusion

This meta-analysis supports the use of transdiagnostic interventions for common mental disorders in primary care. Transdiagnostic interventions carried out by medical and health professionals not specifically trained in psychotherapy are feasible in PC, but emphasis should be placed on adequate training for them.

Trial registration: The protocol for this study is registered with PROSPERO: CRD42024459073, Date of registration: 2024/01/03.

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针对初级保健中常见精神障碍的跨诊断干预措施的系统回顾和荟萃分析

目标在初级医疗中，根据 ICD 或 DSM 治疗常见精神障碍具有挑战性。方法通过检索 Medline、Embase、Web of Science 和 PsycINFO 等数据库，对随机对照试验 (RCT) 进行了系统综述和荟萃分析。结果在最初的 10,618 项随机对照试验中，有 38 项研究被纳入并保留用于数据提取。跨诊断干预显著减轻了抑郁症状（SMD：-0.38）和焦虑症状（SMD：-0.47）。躯体形式障碍的治疗效果不显著（SMD：- 0.22）。约有一半的干预措施是由未接受过心理治疗专门培训的医疗专业人员提供的；这些干预措施也被证明是有效的（抑郁症：SMD：-0.47；焦虑症：-0.39）。由未接受过心理治疗专门培训的医疗卫生专业人员进行跨诊断干预在 PC 中是可行的，但应重视对他们的充分培训：本研究方案已在 PROSPERO 注册：CRD42024459073，注册日期：2024/01/03。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

General hospital psychiatry 医学-精神病学

CiteScore

9.60

自引率

2.90%

发文量

125

审稿时长

20 days

期刊介绍： General Hospital Psychiatry explores the many linkages among psychiatry, medicine, and primary care. In emphasizing a biopsychosocial approach to illness and health, the journal provides a forum for professionals with clinical, academic, and research interests in psychiatry''s role in the mainstream of medicine.