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An interdisciplinary multimodal integrative healthcare program for depressive and anxiety disorders
OBJECTIVE: Although multimodal interventions are recommended in patients with severe depressive and/or anxiety disorders, available evidence is scarce. Therefore, the current study evaluates the effectiveness of an outpatient secondary care interdisciplinary multimodal integrative healthcare program...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326275/ https://www.ncbi.nlm.nih.gov/pubmed/37426091 http://dx.doi.org/10.3389/fpsyt.2023.1113356 |
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author | Wijnen, Jaap Gordon, Nicole Louise van 't Hullenaar, Geert Pont, Marc Lucas Geijselaers, Marciano Wilhelmina Henricus Van Oosterwijck, Jessica de Jong, Jeroen |
author_facet | Wijnen, Jaap Gordon, Nicole Louise van 't Hullenaar, Geert Pont, Marc Lucas Geijselaers, Marciano Wilhelmina Henricus Van Oosterwijck, Jessica de Jong, Jeroen |
author_sort | Wijnen, Jaap |
collection | PubMed |
description | OBJECTIVE: Although multimodal interventions are recommended in patients with severe depressive and/or anxiety disorders, available evidence is scarce. Therefore, the current study evaluates the effectiveness of an outpatient secondary care interdisciplinary multimodal integrative healthcare program, delivered within a transdiagnostic framework, for patients with (comorbid) depressive and/or anxiety disorders. METHODS: Participants were 3,900 patients diagnosed with a depressive and/or anxiety disorder. The primary outcome was Health-Related Quality of Life (HRQoL) measured with the Research and Development-36 (RAND-36). Secondary outcomes included: (1) current psychological and physical symptoms measured with the Brief Symptom Inventory (BSI) and (2) symptoms of depression, anxiety, and stress measured with the Depression Anxiety Stress Scale (DASS). The healthcare program consisted of two active treatment phases: main 20-week program and a subsequent continuation-phase intervention (i.e., 12-month relapse prevention program). Mixed linear models were used to examine the effects of the healthcare program on primary/secondary outcomes over four time points: before start 20-week program (T0), halfway 20-week program (T1), end of 20-week program (T2) and end of 12-month relapse prevention program (T3). RESULTS: Results showed significant improvements from T0 to T2 for the primary variable (i.e., RAND-36) and secondary variables (i.e., BSI/DASS). During the 12-month relapse prevention program, further significant improvements were mainly observed for secondary variables (i.e., BSI/DASS) and to a lesser extent for the primary variable (i.e., RAND-36). At the end of the relapse prevention program (i.e., T3), 63% of patients achieved remission of depressive symptoms (i.e., DASS depression score ≤ 9) and 67% of patients achieved remission of anxiety symptoms (i.e., DASS anxiety score ≤ 7). CONCLUSION: An interdisciplinary multimodal integrative healthcare program, delivered within a transdiagnostic framework, seems effective for patients suffering from depressive and/or anxiety disorders with regard to HRQoL and symptoms of psychopathology. As reimbursement and funding for interdisciplinary multimodal interventions in this patient group has been under pressure in recent years, this study could add important evidence by reporting on routinely collected outcome data from a large patient group. Future studies should further investigate the long-term stability of treatment outcomes after interdisciplinary multimodal interventions for patients suffering from depressive and/or anxiety disorders. |
format | Online Article Text |
id | pubmed-10326275 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-103262752023-07-08 An interdisciplinary multimodal integrative healthcare program for depressive and anxiety disorders Wijnen, Jaap Gordon, Nicole Louise van 't Hullenaar, Geert Pont, Marc Lucas Geijselaers, Marciano Wilhelmina Henricus Van Oosterwijck, Jessica de Jong, Jeroen Front Psychiatry Psychiatry OBJECTIVE: Although multimodal interventions are recommended in patients with severe depressive and/or anxiety disorders, available evidence is scarce. Therefore, the current study evaluates the effectiveness of an outpatient secondary care interdisciplinary multimodal integrative healthcare program, delivered within a transdiagnostic framework, for patients with (comorbid) depressive and/or anxiety disorders. METHODS: Participants were 3,900 patients diagnosed with a depressive and/or anxiety disorder. The primary outcome was Health-Related Quality of Life (HRQoL) measured with the Research and Development-36 (RAND-36). Secondary outcomes included: (1) current psychological and physical symptoms measured with the Brief Symptom Inventory (BSI) and (2) symptoms of depression, anxiety, and stress measured with the Depression Anxiety Stress Scale (DASS). The healthcare program consisted of two active treatment phases: main 20-week program and a subsequent continuation-phase intervention (i.e., 12-month relapse prevention program). Mixed linear models were used to examine the effects of the healthcare program on primary/secondary outcomes over four time points: before start 20-week program (T0), halfway 20-week program (T1), end of 20-week program (T2) and end of 12-month relapse prevention program (T3). RESULTS: Results showed significant improvements from T0 to T2 for the primary variable (i.e., RAND-36) and secondary variables (i.e., BSI/DASS). During the 12-month relapse prevention program, further significant improvements were mainly observed for secondary variables (i.e., BSI/DASS) and to a lesser extent for the primary variable (i.e., RAND-36). At the end of the relapse prevention program (i.e., T3), 63% of patients achieved remission of depressive symptoms (i.e., DASS depression score ≤ 9) and 67% of patients achieved remission of anxiety symptoms (i.e., DASS anxiety score ≤ 7). CONCLUSION: An interdisciplinary multimodal integrative healthcare program, delivered within a transdiagnostic framework, seems effective for patients suffering from depressive and/or anxiety disorders with regard to HRQoL and symptoms of psychopathology. As reimbursement and funding for interdisciplinary multimodal interventions in this patient group has been under pressure in recent years, this study could add important evidence by reporting on routinely collected outcome data from a large patient group. Future studies should further investigate the long-term stability of treatment outcomes after interdisciplinary multimodal interventions for patients suffering from depressive and/or anxiety disorders. Frontiers Media S.A. 2023-06-23 /pmc/articles/PMC10326275/ /pubmed/37426091 http://dx.doi.org/10.3389/fpsyt.2023.1113356 Text en Copyright © 2023 Wijnen, Gordon, van 't Hullenaar, Pont, Geijselaers, Van Oosterwijck and de Jong. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Psychiatry Wijnen, Jaap Gordon, Nicole Louise van 't Hullenaar, Geert Pont, Marc Lucas Geijselaers, Marciano Wilhelmina Henricus Van Oosterwijck, Jessica de Jong, Jeroen An interdisciplinary multimodal integrative healthcare program for depressive and anxiety disorders |
title | An interdisciplinary multimodal integrative healthcare program for depressive and anxiety disorders |
title_full | An interdisciplinary multimodal integrative healthcare program for depressive and anxiety disorders |
title_fullStr | An interdisciplinary multimodal integrative healthcare program for depressive and anxiety disorders |
title_full_unstemmed | An interdisciplinary multimodal integrative healthcare program for depressive and anxiety disorders |
title_short | An interdisciplinary multimodal integrative healthcare program for depressive and anxiety disorders |
title_sort | interdisciplinary multimodal integrative healthcare program for depressive and anxiety disorders |
topic | Psychiatry |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10326275/ https://www.ncbi.nlm.nih.gov/pubmed/37426091 http://dx.doi.org/10.3389/fpsyt.2023.1113356 |
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