Illness burden and physical outcomes associated with collaborative care in patients with comorbid depressive disorder in chronic medical conditions

A systematic review and meta-analysis

J.F. van Eck van der Sluijs, H. Castelijns, V. Eijsbroek, C.A.Th. Rijnders, H.W.J. van Marwijk, C.M. van der Feltz-Cornelis

Research output: Contribution to journalReview articleScientificpeer-review

Abstract

Objective:
Collaborative care (CC) improves depressive symptoms in people with comorbid depressive disorder in chronic medical conditions, but its effect on physical symptoms has not yet systematically been reviewed. This study aims to do so.
Methods:
Systematic review and meta-analysis was conducted using PubMed, the Cochrane Library, and the European and US Clinical Trial Registers. Eligible studies included randomized controlled trials (RCTs) of CC compared to care as usual (CAU), in primary care and general hospital setting, reporting on physical and depressive symptoms as outcomes. Overall treatment effects were estimated for illness burden, physical outcomes and depression, respectively.
Results:
Twenty RCTs were included, with N=4774 patients. The overall effect size of CC versus CAU for illness burden was OR 1.64 (95%CI 1.47;1.83), d=0.27 (95%CI 0.21;0.33). Best physical outcomes in CC were found for hypertension with comorbiddepression. Overall, depression outcomes were better for CC than for CAU. Moderator analyses did not yield statistically significant differences.
Conclusions:
CC is more effective than CAU in terms of illness burden, physical outcomes and depression, in patients with comorbid depression in chronic medical conditions. More research covering multiple medical conditions is needed.
Original languageEnglish
Pages (from-to)1-14
JournalGeneral Hospital Psychiatry: Psychiatry, Medicine and Primary Care
Volume50
DOIs
Publication statusPublished - 2018

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Keywords

  • ACUTE CORONARY SYNDROME
  • ANXIETY DISORDERS
  • CARDIAC EVENTS
  • CLINICAL-TRIAL
  • COST-EFFECTIVENESS
  • Chronic medical disorder
  • Collaborative care
  • Comorbidity
  • Depression
  • Illness burden
  • LOW-INCOME
  • MAJOR DEPRESSION
  • MENTAL-HEALTH CONDITIONS
  • Meta-analysis
  • PSYCHIATRIC-DISORDERS
  • Physical outcomes
  • RANDOMIZED-CONTROLLED-TRIAL
  • Systematic review

Cite this

@article{1429564536fd447ba1572cba4cef4f75,
title = "Illness burden and physical outcomes associated with collaborative care in patients with comorbid depressive disorder in chronic medical conditions: A systematic review and meta-analysis",
abstract = "Objective: Collaborative care (CC) improves depressive symptoms in people with comorbid depressive disorder in chronic medical conditions, but its effect on physical symptoms has not yet systematically been reviewed. This study aims to do so. Methods: Systematic review and meta-analysis was conducted using PubMed, the Cochrane Library, and the European and US Clinical Trial Registers. Eligible studies included randomized controlled trials (RCTs) of CC compared to care as usual (CAU), in primary care and general hospital setting, reporting on physical and depressive symptoms as outcomes. Overall treatment effects were estimated for illness burden, physical outcomes and depression, respectively. Results: Twenty RCTs were included, with N=4774 patients. The overall effect size of CC versus CAU for illness burden was OR 1.64 (95{\%}CI 1.47;1.83), d=0.27 (95{\%}CI 0.21;0.33). Best physical outcomes in CC were found for hypertension with comorbiddepression. Overall, depression outcomes were better for CC than for CAU. Moderator analyses did not yield statistically significant differences. Conclusions: CC is more effective than CAU in terms of illness burden, physical outcomes and depression, in patients with comorbid depression in chronic medical conditions. More research covering multiple medical conditions is needed.",
keywords = "ACUTE CORONARY SYNDROME, ANXIETY DISORDERS, CARDIAC EVENTS, CLINICAL-TRIAL, COST-EFFECTIVENESS, Chronic medical disorder, Collaborative care, Comorbidity, Depression, Illness burden, LOW-INCOME, MAJOR DEPRESSION, MENTAL-HEALTH CONDITIONS, Meta-analysis, PSYCHIATRIC-DISORDERS, Physical outcomes, RANDOMIZED-CONTROLLED-TRIAL, Systematic review",
author = "{van Eck van der Sluijs}, J.F. and H. Castelijns and V. Eijsbroek and C.A.Th. Rijnders and {van Marwijk}, H.W.J. and {van der Feltz-Cornelis}, C.M.",
year = "2018",
doi = "10.1016/j.genhosppsych.2017.08.003",
language = "English",
volume = "50",
pages = "1--14",
journal = "General Hospital Psychiatry: Psychiatry, Medicine and Primary Care",
issn = "0163-8343",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Illness burden and physical outcomes associated with collaborative care in patients with comorbid depressive disorder in chronic medical conditions

T2 - A systematic review and meta-analysis

AU - van Eck van der Sluijs, J.F.

AU - Castelijns, H.

AU - Eijsbroek, V.

AU - Rijnders, C.A.Th.

AU - van Marwijk, H.W.J.

AU - van der Feltz-Cornelis, C.M.

PY - 2018

Y1 - 2018

N2 - Objective: Collaborative care (CC) improves depressive symptoms in people with comorbid depressive disorder in chronic medical conditions, but its effect on physical symptoms has not yet systematically been reviewed. This study aims to do so. Methods: Systematic review and meta-analysis was conducted using PubMed, the Cochrane Library, and the European and US Clinical Trial Registers. Eligible studies included randomized controlled trials (RCTs) of CC compared to care as usual (CAU), in primary care and general hospital setting, reporting on physical and depressive symptoms as outcomes. Overall treatment effects were estimated for illness burden, physical outcomes and depression, respectively. Results: Twenty RCTs were included, with N=4774 patients. The overall effect size of CC versus CAU for illness burden was OR 1.64 (95%CI 1.47;1.83), d=0.27 (95%CI 0.21;0.33). Best physical outcomes in CC were found for hypertension with comorbiddepression. Overall, depression outcomes were better for CC than for CAU. Moderator analyses did not yield statistically significant differences. Conclusions: CC is more effective than CAU in terms of illness burden, physical outcomes and depression, in patients with comorbid depression in chronic medical conditions. More research covering multiple medical conditions is needed.

AB - Objective: Collaborative care (CC) improves depressive symptoms in people with comorbid depressive disorder in chronic medical conditions, but its effect on physical symptoms has not yet systematically been reviewed. This study aims to do so. Methods: Systematic review and meta-analysis was conducted using PubMed, the Cochrane Library, and the European and US Clinical Trial Registers. Eligible studies included randomized controlled trials (RCTs) of CC compared to care as usual (CAU), in primary care and general hospital setting, reporting on physical and depressive symptoms as outcomes. Overall treatment effects were estimated for illness burden, physical outcomes and depression, respectively. Results: Twenty RCTs were included, with N=4774 patients. The overall effect size of CC versus CAU for illness burden was OR 1.64 (95%CI 1.47;1.83), d=0.27 (95%CI 0.21;0.33). Best physical outcomes in CC were found for hypertension with comorbiddepression. Overall, depression outcomes were better for CC than for CAU. Moderator analyses did not yield statistically significant differences. Conclusions: CC is more effective than CAU in terms of illness burden, physical outcomes and depression, in patients with comorbid depression in chronic medical conditions. More research covering multiple medical conditions is needed.

KW - ACUTE CORONARY SYNDROME

KW - ANXIETY DISORDERS

KW - CARDIAC EVENTS

KW - CLINICAL-TRIAL

KW - COST-EFFECTIVENESS

KW - Chronic medical disorder

KW - Collaborative care

KW - Comorbidity

KW - Depression

KW - Illness burden

KW - LOW-INCOME

KW - MAJOR DEPRESSION

KW - MENTAL-HEALTH CONDITIONS

KW - Meta-analysis

KW - PSYCHIATRIC-DISORDERS

KW - Physical outcomes

KW - RANDOMIZED-CONTROLLED-TRIAL

KW - Systematic review

U2 - 10.1016/j.genhosppsych.2017.08.003

DO - 10.1016/j.genhosppsych.2017.08.003

M3 - Review article

VL - 50

SP - 1

EP - 14

JO - General Hospital Psychiatry: Psychiatry, Medicine and Primary Care

JF - General Hospital Psychiatry: Psychiatry, Medicine and Primary Care

SN - 0163-8343

ER -