Faisal, Mehreen Riaz orcid.org/0000-0002-2725-572X, Salam, Fakiha Tus, Vidyasagaran, Aishwarya Lakshmi orcid.org/0000-0002-9858-0685 et al. (7 more authors) (2024) Collaborative care for common mental disorders in low- and middle-income countries:A systematic review and meta-analysis. Journal of affective disorders. pp. 595-608. ISSN 0165-0327
Abstract
Background: Low- and middle-income countries (LMICs) face high burden of common mental disorders (CMDs). Most of the evidence for the Collaborative Care (CC) model effectiveness comes from high-income countries (HICs) and may not generalise to LMICs. A systematic review was conducted to assess effectiveness of CC for CMDs in LMICs. Methods: We searched eight-databases, two trial registries (2011-November 2023). Randomised controlled trials (RCTs) of adults (≥18 years) with depression/anxiety diagnosis, reporting remission/change in symptom severity were eligible. Random effects meta-analyses were conducted for: short-(0–6 months), medium-(7–12 months), long-(13–24 months), and very long-term (≥25 months) follow-up. Quality was assessed with Cochrane RoB2 tool. PROSPERO registration: CRD42022380407. Results: Searches identified 7494 studies, 12 trials involving 13,531 participants were included; nine had low-risk of bias. CC was more effective than usual care for depression: dichotomous outcomes (short-term, 7 studies, relative risk (RR) 1.39, 95%CI 1.31, 1.48; medium-term, 6 studies, RR 1.35, 95%CI 1.28, 1.43); and continuous outcomes (short-term, 8 studies, standardised mean difference (SMD) −0.51, 95%CI −0.80, −0.23; medium-term, 8 studies, SMD −0.59, 95%CI −1.00, −0.17). CC was found to be effective at long-term (one study), but not at very long-term. Improvement in anxiety outcomes with CC (2 studies, 340 participants) reported up to 12-months; improvements in quality-of-life were not statistically significant (3 studies, 796 participants, SMD 0.62, 95%CI −0.10, 1.34). Limitations: Pooled estimates showed high heterogeneity. Conclusions: In LMICs, CC was more effective than usual care for improving depression outcomes at short and medium-term follow-up. A similar improvement was found for anxiety outcomes, but evidence is limited.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 The Author(s) |
Keywords: | Anxiety,Collaborative care,Depression,Low- and middle-income countries,Task-shifting |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Health Sciences (York) The University of York > Faculty of Social Sciences (York) > Centre for Reviews and Dissemination (York) The University of York > Faculty of Sciences (York) > Hull York Medical School (York) |
Depositing User: | Pure (York) |
Date Deposited: | 08 Aug 2024 16:20 |
Last Modified: | 13 Mar 2025 05:30 |
Published Version: | https://doi.org/10.1016/j.jad.2024.07.086 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1016/j.jad.2024.07.086 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:215903 |
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