Trial reportTrials2011
Stepped care treatment for depression and anxiety in primary care. a randomized controlled trial.
Trial report in Trials, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Contemporary treatment of anxiety in primary care: a systematic review and meta-analysis of outcomes in countries with universal healthcare.BMC family practice · 2021Pooled it
- Statistical design and analysis in trials of proportionate interventions: a systematic review.Trials · 2019Pooled it
- Utility scores for different health states related to depression: individual participant data analysis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2017Pooled it
- The Efficacy and Cost-Effectiveness of Stepped Care Prevention and Treatment for Depressive and/or Anxiety Disorders: A Systematic Review and Meta-Analysis.Scientific reports · 2016Pooled it
- Matching depression management to severity prognosis in primary care: results of the Target-D randomised controlled trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Trial
- Stepped-care versus treatment as usual in panic disorder: A randomized controlled trial.PloS one · 2020Trial
- Cost-effectiveness analysis of a randomized study of depression treatment options in primary care suggests stepped-care treatment may have economic benefits.BMC psychiatry · 2019Trial
- PsyScan e-tool to support diagnosis and management of psychological problems in general practice: a randomised controlled trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Trial
- Trial
- Scoping review of stepped care interventions for mental health and substance use service delivery to youth and young adults.Early intervention in psychiatry · 2022Article
- Preliminary results of adapting the stepped care model for depression management in Vietnam.Frontiers in psychiatry · 2022Article
- Factors influencing psychological distress and effects of stepwise psychological care on quality of life in patients undergoing chemotherapy after breast cancer surgery.American journal of translational research · 2022Article
- An integrated approach to meet the needs of high-vulnerable families: a qualitative study on integrated care from a professional perspective.Child and adolescent psychiatry and mental health · 2020Article
- Article
- Predictors of Number of Healthcare Professionals Consulted by Individuals with Mental Disorders or High Psychological Distress.International journal of environmental research and public health · 2019Article
- Evaluation of a Sudarshan Kriya Yoga (SKY) based breath intervention for patients with mild-to-moderate depression and anxiety disorders.Primary health care research & development · 2019Article
- Implementation of Integrated Service Networks under the Quebec Mental Health Reform: Facilitators and Barriers associated with Different Territorial Profiles.International journal of integrated care · 2017Article
- Depression Outcomes in Adults Attending Family Practice Were Not Improved by Screening, Stepped-Care, or Online CBT during a 12-Week Study when Compared to Controls in a Randomized Trial.Frontiers in psychiatry · 2017Article
- Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDepressive and anxiety disorders are common in general practice but not always treated adequately. Introducing stepped care might improve this. In this randomized trial we examined the effectiveness of such a stepped care model.
methodsThe study population consisted of primary care attendees aged 18-65 years with minor or major DSM-IV depressive and/or anxiety disorders, recruited through screening. We randomized 120 patients to either stepped care or care as usual. The stepped care program consisted of (1) watchful waiting, (2) guided self-help, (3) short face-to-face problem solving treatment and (4) pharmacotherapy and/or specialized mental health care. Patients were assessed at baseline and after 8, 16 and 24 weeks.
resultsSymptoms of depression and anxiety decreased significantly over time for both groups. However, there was no statistically significant difference between the two groups (IDS: P = 0.35 and HADS: P = 0.64). The largest, but not significant, effect (d = -0.21) was found for anxiety on T3. In both groups approximately 48% of the patients were recovered from their DSM-IV diagnosis at the final 6 months assessment.
conclusionsIn summary we could not demonstrate that stepped care for depression and anxiety in general practice was more effective than care as usual. Possible reasons are discussed.
trial registrationCurrent Controlled Trails: ISRCTN17831610.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.