Declaration of interest
Long-term conditions often coexist with depression and anxiety.
To assess the effectiveness of stepped-care psychological therapies for patients with long-term conditions.
Data from 28 498 patients were analysed using regression to model depression (Patient Health Questionnaire (PHQ-9)) and anxiety (Generalised Anxiety Disorder scale (GAD-7)) outcomes. Post-treatment symptoms and effect sizes (d) were estimated for individuals with and without long-term conditions, controlling for covariates. The likelihood of access and response to intensive psychological interventions was also examined.
Higher post-treatment symptoms were predicted for patients with musculoskeletal problems (d = 0.22–0.27), chronic obstructive pulmonary disease (d = 0.26–0.33), diabetes (d = 0.05–0.13) and psychotic disorders (d = 0.50–0.58). Most long-term conditions were associated with greater odds of accessing high-intensity therapies, yet individuals who accessed these continued to have higher average post-treatment symptoms.
Some long-term conditions are associated with greater intensity of care and poorer outcomes after therapy.
This study was funded by Leeds Community Healthcare NHS Trust and commissioned by the Long Term Conditions Project Team, Leeds, UK, January 2016.
- © The Royal College of Psychiatrists 2017.
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