1. Effectiveness of collaborative care in reducing suicidal ideation: An individual participant data meta-analysis
- Author
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Bruce L. Rollman, David A. Adler, Peter Bower, Karina Lovell, Christina M. van der Feltz-Cornelis, Enric Aragones, Kenneth B. Wells, Martin G. Cole, Alexander Hodkinson, Marco Menchetti, Joan Russo, Simon Gilbody, Chris Dickens, Amy Blakemore, Jochen Gensichen, Moniek C. Zijlstra-Vlasveld, K.M.L. Huijbregts, Nancy K. Grote, Martha L. Bruce, Vikram Patel, Maria Panagioti, Salwa S Zghebi, Marta Buszewicz, Janine Archer, Karina W. Davidson, Cecilia Björkelund, Jürgen Unützer, David Richards, Waquas Waheed, Thomas Zimmermann, Christos Grigoroglou, Evangelos Kontopantelis, A. Smit, Jeff C. Huffman, Robert M. Carney, Peter A. Coventry, Grigoroglou C., van der Feltz-Cornelis C., Hodkinson A., Coventry P.A., Zghebi S.S., Kontopantelis E., Bower P., Lovell K., Gilbody S., Waheed W., Dickens C., Archer J., Blakemore A., Adler D.A., Aragones E., Bjorkelund C., Bruce M.L., Buszewicz M., Carney R.M., Cole M.G., Davidson K.W., Gensichen J., Grote N.K., Russo J., Huijbregts K., Huffman J.C., Menchetti M., Patel V., Richards D.A., Rollman B., Smit A., Zijlstra-Vlasveld M.C., Wells K.B., Zimmermann T., Unutzer J., and Panagioti M.
- Subjects
Adult ,medicine.medical_specialty ,MEDLINE ,Psychological intervention ,Collaborative Care ,CINAHL ,PsycINFO ,Anxiety ,Suicidal Ideation ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,030212 general & internal medicine ,Psychiatry ,Suicidal ideation ,Primary Care ,Depression (differential diagnoses) ,Aged ,Individual participant data analysis ,Primary Health Care ,business.industry ,030227 psychiatry ,suicidal ideation ,Meta-analysis ,Psychiatry and Mental health ,Collaborative care ,medicine.symptom ,business ,Human - Abstract
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. 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. 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 , 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]). 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. [Abstract copyright: Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.]
- Published
- 2021
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