Stepped Care Vs. Matched Care for Mood and Anxiety Disorders: a Randomized Trial in Routine Practice

Overview

Journal Acta Psychiatr Scand

Specialty Psychiatry

Date 2006 May 9

PMID 16677223

Citations 18

Authors

A van Straten

B Tiemens

L Hakkaart

W A Nolen

M C H Donker

Affiliations

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Abstract

Objective: The effectiveness of two versions of stepped care [with either brief therapy (BT) or cognitive behavioural therapy (CBT) as a first step] is studied in comparison with the traditional matched care approach (CAU) for patients with mood and anxiety disorders.

Method: A randomized trial was performed in routine mental health care in 12 settings, including 702 patients. Patients were interviewed once in 3 months for 18-24 months (response rate 69%).

Results: Overall, patients' health improved significantly over time: 51% had achieved recovery from the DSM-IV disorder(s) after 1 year and 66% at the end of the study. Respectively, 50% and 60% had 'normal' SCL90 and SF36 scores. Cognitive behavioural therapy and BT patients achieved recovery more often than CAU patients (ORs between 1.26 and 1.48), although these results were not statistically significant.

Conclusion: Stepped care, with BT or CBT as a first step, is at least as effective as matched care.

Citing Articles

Beyond effectiveness in eHealth trials: Process evaluation of a stepped-care programme to support healthcare workers with psychological distress (RESPOND-HCWs).

Mediavilla R, Garcia-Vazquez B, McGreevy K, Underhill J, Bayon C, Bravo-Ortiz M Digit Health. 2024; 10:20552076241287678.

PMID: 39430699 PMC: 11489946. DOI: 10.1177/20552076241287678.

Development and psychometric evaluation of the Transdiagnostic Decision Tool: matched care for patients with a mental disorder in need of highly specialised care.

van Krugten F, van der Feltz-Cornelis C, Boeschoten M, van Broeckhuysen-Kloth S, van Eck van der Sluijs J, van Ee E BJPsych Open. 2023; 6(5):e93.

PMID: 38058113 PMC: 7488321. DOI: 10.1192/bjo.2020.74.

A Web-Based Stratified Stepped Care Mental Health Platform (TourHeart): Semistructured Interviews With Stakeholders.

Tsoi E, Mak W, Ho C, Yeung G JMIR Hum Factors. 2022; 9(2):e35057.

PMID: 35560109 PMC: 9143776. DOI: 10.2196/35057.

Process evaluation of Prompt Mental Health Care (PMHC): the Norwegian version of Improving Access to Psychological Therapies.

Lervik L, Knapstad M, Smith O BMC Health Serv Res. 2020; 20(1):437.

PMID: 32430000 PMC: 7236093. DOI: 10.1186/s12913-020-05311-5.

Personalized prognostic prediction of treatment outcome for depressed patients in a naturalistic psychiatric hospital setting: A comparison of machine learning approaches.

Webb C, Cohen Z, Beard C, Forgeard M, Peckham A, Bjorgvinsson T J Consult Clin Psychol. 2019; 88(1):25-38.

PMID: 31841022 PMC: 6924628. DOI: 10.1037/ccp0000451.