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Salomonsson S, Santoft F, Lindsäter E, Ejeby K, Ingvar M, Öst LG, Lekander M, Ljótsson B, Hedman-Lagerlöf E. Predictors of outcome in guided self-help cognitive behavioural therapy for common mental disorders in primary care. Cogn Behav Ther 2019; 49:455-474. [PMID: 31638472 DOI: 10.1080/16506073.2019.1669701] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Cognitive behavioural therapy (CBT) can effectively treat common mental disorders (CMDs), but access to treatment is insufficient. Guided self-help (GSH) CBT has shown effects comparable to face-to-face CBT and may be a resource-efficient treatment alternative. However, not all patients respond to GSH. Learning more about predictors of outcome may increase knowledge regarding which patients respond to GSH. The aim of this study was to investigate predictors of outcome for GSH CBT for patients with CMDs in primary care. Consecutive patients (N = 396) with a principal disorder of depression, anxiety, insomnia or stress-related disorders were included. All patients received GSH CBT. Outcomes were remission status, reliable change and post-treatment depression ratings. Predictors investigated were clinical, demographic and therapy-related variables. Analyses were conducted using logistic and linear regression. Higher educational level predicted remission, higher quality of life ratings predicted remission and decreased depression, and higher age at onset predicted reliable change. Therapy-related variables, i.e. patient adherence to treatment and patients' and clinicians' estimation of treatment response, were all related to outcome. More large-scale studies are needed, but the present study points at the importance of therapy-related variables such as monitoring and supporting treatment adherence for an increased chance of remission.
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Affiliation(s)
- Sigrid Salomonsson
- Center for Psychiatry Research, Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet , Stockholm, Sweden
| | - Fredrik Santoft
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet , Stockholm, Sweden
| | - Elin Lindsäter
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet , Stockholm, Sweden
| | - Kersti Ejeby
- Department of Neurobiology, Care Sciences and Society (NVS), H1, Division of Family medicine, Karolinska Institutet , Stockholm, Sweden
| | - Martin Ingvar
- Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet , Stockholm, Sweden.,Department of Neuroradiology, Karolinska University Hospital , Stockholm, Sweden
| | - Lars-Göran Öst
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet , Stockholm, Sweden.,Department of Psychology, Stockholm University , Stockholm, Sweden
| | - Mats Lekander
- Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet , Stockholm, Sweden.,Department of Neuroradiology, Karolinska University Hospital , Stockholm, Sweden.,Stress Research Institute, Stockholm University , Stockholm, Sweden
| | - Brjánn Ljótsson
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet , Stockholm, Sweden
| | - Erik Hedman-Lagerlöf
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet , Stockholm, Sweden.,Department of Clinical Neuroscience, Osher Center for Integrative Medicine, Karolinska Institutet , Stockholm, Sweden.,Department of Neuroradiology, Karolinska University Hospital , Stockholm, Sweden
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