Effectiveness of collaborative care in reducing suicidal ideation: An individual participant data meta-analysis

被引：14

作者：

Grigoroglou, Christos ^{[1
]}

Van der Feltz-Cornelis, Christina ^{[3
]}

Hodkinson, Alexander ^{[2
]}

Coventry, Peter A. ^{[4
]}

Zghebi, Salwa S. ^{[2
]}

Kontopantelis, Evangelos ^{[5
]}

Bower, Peter ^{[2
]}

Lovell, Karina ^{[6
,7
]}

Gilbody, Simon ^{[3
]}

Waheed, Waquas ^{[2
]}

Dickens, Christopher ^{[8
]}

Archer, Janine ^{[9
]}

Blakemore, Amy ^{[6
]}

Adler, David A. ^{[10
,11
,12
]}

Aragones, Enric ^{[13
]}

Bjorkelund, Cecilia ^{[14
]}

Bruce, Martha L. ^{[15
]}

Buszewicz, Marta ^{[16
]}

Carney, Robert M. ^{[17
]}

Cole, Martin G. ^{[18
]}

Davidson, Karina W. ^{[19
]}

Gensichen, Jochen ^{[20
]}

Grote, Nancy K. ^{[21
]}

Russo, Joan ^{[22
]}

Huijbregts, Klaas ^{[23
,24
]}

Huffman, Jeff C. ^{[25
]}

Menchetti, Marco ^{[26
]}

Patel, Vikram ^{[27
]}

Richards, David A. ^{[28
,29
]}

Rollman, Bruce ^{[30
]}

Smit, Annet ^{[31
]}

Zijlstra-Vlasveld, Moniek C. ^{[32
]}

Wells, Kenneth B. ^{[33
,34
]}

Zimmermann, Thomas ^{[35
]}

Unutzer, Jurgen ^{[22
]}

Panagioti, Maria ^{[2
]}

机构：

[1] Univ Manchester, Hlth Serv Res & Primary Care, Div Populat Hlth, Manchester, Lancs, England

[2] Univ Manchester, Res Sch Primary Care Res, Hlth Serv Res & Primary Care, Div Populat Hlth,Natl Inst Hlth, Manchester, Lancs, England

[3] Univ York, Hull York Med Sch, Dept Hlth Sci, HYMS, York, N Yorkshire, England

[4] Univ York, Dept Hlth Sci, York, N Yorkshire, England

[5] Univ Manchester, Fac Biol Med & Hlth, Div Informat Imaging & Data Sci, Manchester, Lancs, England

[6] Univ Manchester, Sch Hlth Sci, Div Nursing Midwifery & Social Work, Manchester, Lancs, England

[7] Greater Manchester Mental Hlth NHS Fdn Trust, Manchester, Lancs, England

[8] Univ Exeter, Mental Hlth Res Grp, Med Sch, Exeter, Devon, England

[9] Univ Salford, Sch Hlth & Soc, Salford, Lancs, England

[10] Tufts Med Ctr, Dept Psychiat, Boston, MA USA

[11] Tufts Med Ctr, Dept Med, Boston, MA USA

[12] Tufts Univ, Sch Med, Boston, MA 02111 USA

[13] Inst Univ Invest Atencio Primaria Jordi Gol IDIAP, Barcelona, Spain

[14] Univ Gothenburg, Primary Hlth Care Sch Publ Hlth & Community Med, Gothenburg, Sweden

[15] Geisel Sch Med Dartmouth, Dept Psychiat, Hanover, NH USA

[16] UCL, Fac Populat & Hlth Sci, Inst Epidemiol & Hlth, London, England

[17] Washington Univ, Dept Psychiat, St Louis, MO USA

[18] McGill Univ, Dept Psychiat, St Marys Hosp Ctr, Montreal, PQ, Canada

[19] Northwell Health, Feinstein Inst Med Res, Inst Hlth Innovat & Outcomes Res, Manhasset, NY USA

[20] Ludwig Maximilians Univ Munchen, LMU Klinikum, Inst Gen Practice & Family Med, Pettenkoferstr 10, D-80336 Munich, Germany

[21] Univ Washington, Sch Social Work, Seattle, WA 98195 USA

[22] Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA

[23] Dept Psychiat, Amsterdam, Netherlands

[24] Amsterdam Publ Hlth Res Inst, Amsterdam, Netherlands

[25] Harvard Med Sch, Dept Psychiat, Massachusetts Gen Hosp, Boston, MA USA

[26] Univ Bologna, Dept Biomed & Neuromotor Sci, Bologna, Italy

[27] Harvard Med Sch, Global Hlth, Boston, MA 02115 USA

[28] Univ Exeter, Inst Hlth Res, Coll Med & Hlth, Exeter, Devon, England

[29] Western Univ Norway, Bergen, Norway

[30] Univ Pittsburgh, Sch Med, Ctr Behav Hlth Media & Technol, Pittsburgh, PA USA

[31] HAN Univ Appl Sci, Nijmegen, Netherlands

[32] Netherlands Org Hlth Res & Dev, ZonMw, The Hague, Netherlands

[33] Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA

[34] Univ Calif Los Angeles, Jane & Terry Semel Inst Neurosci & Human Behav, Los Angeles, CA USA

[35] Univ Med Ctr Hamburg Eppendorf, Ctr Psychosocial Med, Dept Gen Practice Primary Care, Hamburg, Germany

来源：

GENERAL HOSPITAL PSYCHIATRY | 2021年 / 71卷

基金：

英国医学研究理事会;

关键词：

MAJOR DEPRESSIVE DISORDER; PHYSICAL CONDITIONS; ANXIETY DISORDERS; PATIENT-DATA; MANAGEMENT; HEALTH; SYMPTOMS; IMPACT; TRIAL; HETEROGENEITY;

D O I：

10.1016/j.genhosppsych.2021.04.004

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

To assess whether CC is more effective at reducing suicidal ideation in people with depression compared with usual care, and whether study and patient factors moderate treatment effects. Method: We searched Medline, Embase, PubMed, PsycINFO, CINAHL, CENTRAL from inception to March 2020 for Randomised Controlled Trials (RCTs) that compared the effectiveness of CC with usual care in depressed adults, and reported changes in suicidal ideation at 4 to 6 months post-randomisation. Mixed-effects models accounted for clustering of participants within trials and heterogeneity across trials. This study is registered with PROSPERO, CRD42020201747. Results: We extracted data from 28 RCTs (11,165 patients) of 83 eligible studies. We observed a small significant clinical improvement of CC on suicidal ideation, compared with usual care (SMD, 0.11 [95%CI, 0.15 to 0.08]; I-2, 0.47% [95%CI 0.04% to 4.90%]). CC interventions with a recognised psychological treatment were associated with small reductions in suicidal ideation (SMD, 0.15 [95%CI -0.19 to 0.11]). CC was more effective for reducing suicidal ideation among patients aged over 65 years (SMD, 0.18 [95%CI -0.25 to 0.11]). Conclusion: Primary care based CC with an embedded psychological intervention is the most effective CC framework for reducing suicidal ideation and older patients may benefit the most.

引用

页码：27 / 35

页数：9

共 79 条

[1] A 5-Year Observational Study of Patients With Treatment-Resistant Depression Treated With Vagus Nerve Stimulation or Treatment as Usual: Comparison of Response, Remission, and Suicidality [J].