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Is social support pre‐treatment associated with prognosis for adults with depression in primary care?
OBJECTIVE: Depressed patients rate social support as important for prognosis, but evidence for a prognostic effect is lacking. We aimed to test the association between social support and prognosis independent of treatment type, and the severity of depression, and other clinical features indicating a...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7610633/ https://www.ncbi.nlm.nih.gov/pubmed/33548056 http://dx.doi.org/10.1111/acps.13285 |
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author | Buckman, Joshua E. J. Saunders, Rob O’Driscoll, Ciaran Cohen, Zachary D. Stott, Joshua Ambler, Gareth Gilbody, Simon Hollon, Steven D. Kendrick, Tony Watkins, Edward Wiles, Nicola Kessler, David Chari, Nomsa White, Ian R. Lewis, Glyn Pilling, Stephen |
author_facet | Buckman, Joshua E. J. Saunders, Rob O’Driscoll, Ciaran Cohen, Zachary D. Stott, Joshua Ambler, Gareth Gilbody, Simon Hollon, Steven D. Kendrick, Tony Watkins, Edward Wiles, Nicola Kessler, David Chari, Nomsa White, Ian R. Lewis, Glyn Pilling, Stephen |
author_sort | Buckman, Joshua E. J. |
collection | PubMed |
description | OBJECTIVE: Depressed patients rate social support as important for prognosis, but evidence for a prognostic effect is lacking. We aimed to test the association between social support and prognosis independent of treatment type, and the severity of depression, and other clinical features indicating a more severe illness. METHODS: Individual patient data were collated from all six eligible RCTs (n = 2858) of adults seeking treatment for depression in primary care. Participants were randomized to any treatment and completed the same baseline assessment of social support and clinical severity factors. Two‐stage random effects meta‐analyses were conducted. RESULTS: Social support was associated with prognosis independent of randomized treatment but effects were smaller when adjusting for depressive symptoms and durations of depression and anxiety, history of antidepressant treatment, and comorbid panic disorder: percentage decrease in depressive symptoms at 3–4 months per z‐score increase in social support = −4.14(95%CI: −6.91 to −1.29). Those with a severe lack of social support had considerably worse prognoses than those with no lack of social support: increase in depressive symptoms at 3–4 months = 14.64%(4.25% to 26.06%). CONCLUSIONS: Overall, large differences in social support pre‐treatment were associated with differences in prognostic outcomes. Adding the Social Support scale to clinical assessments may be informative, but after adjusting for routinely assessed clinical prognostic factors the differences in prognosis are unlikely to be of a clinically important magnitude. Future studies might investigate more intensive treatments and more regular clinical reviews to mitigate risks of poor prognosis for those reporting a severe lack of social support. |
format | Online Article Text |
id | pubmed-7610633 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-76106332021-05-01 Is social support pre‐treatment associated with prognosis for adults with depression in primary care? Buckman, Joshua E. J. Saunders, Rob O’Driscoll, Ciaran Cohen, Zachary D. Stott, Joshua Ambler, Gareth Gilbody, Simon Hollon, Steven D. Kendrick, Tony Watkins, Edward Wiles, Nicola Kessler, David Chari, Nomsa White, Ian R. Lewis, Glyn Pilling, Stephen Acta Psychiatr Scand Systematic Review or Meta‐analysis OBJECTIVE: Depressed patients rate social support as important for prognosis, but evidence for a prognostic effect is lacking. We aimed to test the association between social support and prognosis independent of treatment type, and the severity of depression, and other clinical features indicating a more severe illness. METHODS: Individual patient data were collated from all six eligible RCTs (n = 2858) of adults seeking treatment for depression in primary care. Participants were randomized to any treatment and completed the same baseline assessment of social support and clinical severity factors. Two‐stage random effects meta‐analyses were conducted. RESULTS: Social support was associated with prognosis independent of randomized treatment but effects were smaller when adjusting for depressive symptoms and durations of depression and anxiety, history of antidepressant treatment, and comorbid panic disorder: percentage decrease in depressive symptoms at 3–4 months per z‐score increase in social support = −4.14(95%CI: −6.91 to −1.29). Those with a severe lack of social support had considerably worse prognoses than those with no lack of social support: increase in depressive symptoms at 3–4 months = 14.64%(4.25% to 26.06%). CONCLUSIONS: Overall, large differences in social support pre‐treatment were associated with differences in prognostic outcomes. Adding the Social Support scale to clinical assessments may be informative, but after adjusting for routinely assessed clinical prognostic factors the differences in prognosis are unlikely to be of a clinically important magnitude. Future studies might investigate more intensive treatments and more regular clinical reviews to mitigate risks of poor prognosis for those reporting a severe lack of social support. John Wiley and Sons Inc. 2021-02-16 2021-05 /pmc/articles/PMC7610633/ /pubmed/33548056 http://dx.doi.org/10.1111/acps.13285 Text en © 2021 The Authors. Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Systematic Review or Meta‐analysis Buckman, Joshua E. J. Saunders, Rob O’Driscoll, Ciaran Cohen, Zachary D. Stott, Joshua Ambler, Gareth Gilbody, Simon Hollon, Steven D. Kendrick, Tony Watkins, Edward Wiles, Nicola Kessler, David Chari, Nomsa White, Ian R. Lewis, Glyn Pilling, Stephen Is social support pre‐treatment associated with prognosis for adults with depression in primary care? |
title | Is social support pre‐treatment associated with prognosis for adults with depression in primary care? |
title_full | Is social support pre‐treatment associated with prognosis for adults with depression in primary care? |
title_fullStr | Is social support pre‐treatment associated with prognosis for adults with depression in primary care? |
title_full_unstemmed | Is social support pre‐treatment associated with prognosis for adults with depression in primary care? |
title_short | Is social support pre‐treatment associated with prognosis for adults with depression in primary care? |
title_sort | is social support pre‐treatment associated with prognosis for adults with depression in primary care? |
topic | Systematic Review or Meta‐analysis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7610633/ https://www.ncbi.nlm.nih.gov/pubmed/33548056 http://dx.doi.org/10.1111/acps.13285 |
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