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A Systematic Review and Meta-Analysis of Measurement Feedback Systems in Treatment for Common Mental Health Disorders.

ABSTRACT: To investigate the effects of measurement feedback systems (MFSs) in therapy on mental health outcomes through a literature review and meta-analysis. Using a three-level modeling approach, we conducted a meta-analysis of all effect sizes from randomized controlled studies of MFSs used in the treatment of common mental health disorders. Eighty-two effect sizes were extracted from the thirty-one included studies. Analyses were performed to consider the post-treatment effects of the MFS-assisted treatment compared to treatment as usual. A separate analysis was done for the subgroup "not-on-track" patients as it is theorized that MFSs will be clinically useful because they make therapists aware of patients who fail to progress. MFSs had a significant effect on mental health outcomes (d = 0.14, 95% CI [0.082-0.206], p < .001). Further analysis found a larger effect in patients identified as less respondent to therapy, the "not-on-track" group (d = 0.29, 95% CI [0.114, 0.464], p = .003). Moderation analyses indicated that the type of outcome measurement and type of feedback system used, and whether it was used for a child and youth or adult population, influenced effect sizes. MFSs seem to have a small positive effect on treatment outcomes. The effects seem to be larger for "not-on-track" patients, the group of patients that would usually not benefit much from treatment.

SUBMITTER: Rognstad K

PROVIDER: S-EPMC9931854 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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A Systematic Review and Meta-Analysis of Measurement Feedback Systems in Treatment for Common Mental Health Disorders.

Rognstad Kristian K Wentzel-Larsen Tore T Neumer Simon-Peter SP Kjøbli John J

Administration and policy in mental health 20221125 2

To investigate the effects of measurement feedback systems (MFSs) in therapy on mental health outcomes through a literature review and meta-analysis. Using a three-level modeling approach, we conducted a meta-analysis of all effect sizes from randomized controlled studies of MFSs used in the treatment of common mental health disorders. Eighty-two effect sizes were extracted from the thirty-one included studies. Analyses were performed to consider the post-treatment effects of the MFS-assisted tr ...[more]

PMID: 36434313

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Project description:BackgroundThere is a large treatment gap for common mental disorders (CMD), with wide variation by world region. This review identifies factors associated with formal health service utilisation for CMD in the general adult population, and compares evidence from high-income countries (HIC) with that from low-and-middle-income countries (LMIC).MethodsWe searched MEDLINE, PsycINFO, EMBASE and Scopus in May 2016. Eligibility criteria were: published in English, in peer-reviewed journals; using population-based samples; employing standardised CMD measures; measuring use of formal health services for mental health reasons by people with CMD; testing the association between this outcome and any other factor(s). Risk of bias was assessed using the adapted Mixed Methods Appraisal Tool. We synthesised the results using "best fit framework synthesis", with reference to the Andersen socio-behavioural model.ResultsFifty two studies met inclusion criteria. 46 (88%) were from HIC. Predisposing factors: There was evidence linking increased likelihood of service use with female gender; Caucasian ethnicity; higher education levels; and being unmarried; although this was not consistent across all studies. Need factors: There was consistent evidence of an association between service utilisation and self-evaluated health status; duration of symptoms; disability; comorbidity; and panic symptoms. Associations with symptom severity were frequently but less consistently reported. Enabling factors: The evidence did not support an association with income or rural residence. Inconsistent evidence was found for associations between unemployment or having health insurance and use of services. There was a lack of research from LMIC and on contextual level factors.ConclusionIn HIC, failure to seek treatment for CMD is associated with less disabling symptoms and lack of perceived need for healthcare, consistent with suggestions that "treatment gap" statistics over-estimate unmet need for care as perceived by the target population. Economic factors and urban/rural residence appear to have little effect on treatment-seeking rates. Strategies to address potential healthcare inequities for men, ethnic minorities, the young and the elderly in HIC require further evaluation. The generalisability of these findings beyond HIC is limited. Future research should examine factors associated with health service utilisation for CMD in LMIC, and the effect of health systems and neighbourhood factors.Trial registrationPROSPERO registration number: 42016046551 .

Project description:BackgroundSince the introduction of specified diagnostic criteria for mental disorders in the 1970s, there has been a rapid expansion in the number of large-scale mental health surveys providing population estimates of the combined prevalence of common mental disorders (most commonly involving mood, anxiety and substance use disorders). In this study we undertake a systematic review and meta-analysis of this literature.MethodsWe applied an optimized search strategy across the Medline, PsycINFO, EMBASE and PubMed databases, supplemented by hand searching to identify relevant surveys. We identified 174 surveys across 63 countries providing period prevalence estimates (155 surveys) and lifetime prevalence estimates (85 surveys). Random effects meta-analysis was undertaken on logit-transformed prevalence rates to calculate pooled prevalence estimates, stratified according to methodological and substantive groupings.ResultsPooling across all studies, approximately 1 in 5 respondents (17.6%, 95% confidence interval:16.3-18.9%) were identified as meeting criteria for a common mental disorder during the 12-months preceding assessment; 29.2% (25.9-32.6%) of respondents were identified as having experienced a common mental disorder at some time during their lifetimes. A consistent gender effect in the prevalence of common mental disorder was evident; women having higher rates of mood (7.3%:4.0%) and anxiety (8.7%:4.3%) disorders during the previous 12 months and men having higher rates of substance use disorders (2.0%:7.5%), with a similar pattern for lifetime prevalence. There was also evidence of consistent regional variation in the prevalence of common mental disorder. Countries within North and South East Asia in particular displayed consistently lower one-year and lifetime prevalence estimates than other regions. One-year prevalence rates were also low among Sub-Saharan-Africa, whereas English speaking counties returned the highest lifetime prevalence estimates.ConclusionsDespite a substantial degree of inter-survey heterogeneity in the meta-analysis, the findings confirm that common mental disorders are highly prevalent globally, affecting people across all regions of the world. This research provides an important resource for modelling population needs based on global regional estimates of mental disorder. The reasons for regional variation in mental disorder require further investigation.

Project description:BackgroundCommon mental disorders are a major public health concern in the world and negatively influence people's psychological, physical, economic, and overall well-being. Since prisoners live with restricted freedom and lack regular social interaction like communication with family and friends, the prevalence of common mental disorders is frequently found to be higher among prisoners compared to the general population. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of common mental disorders and their associated factors among prisoners in Ethiopia.MethodsThe primary published studies were searched by using different databases like PubMed, Google Scholar, CINHAL, and African Journal Online. A total of eight primary articles that assessed the prevalence and associated factors of common mental disorders among Ethiopian prisoners were included in this systematic review and meta-analysis. The data were extracted using the data extraction format in a Microsoft Excel spreadsheet and exported to Stata version 14 for further analysis. The statistical heterogeneity was assessed by the I2 test. Due to the presence of heterogeneity among included studies, a random effect meta-analysis model was employed. Egger's weighted regression test and funnel plots were used to check the presence of publication bias.ResultsA total of 8 primary studies with 3,585 study participants were included in this systematic review and meta-analysis. The pooled prevalence of common mental disorders among Ethiopian prisoners was 62.29% with a 95% CI (50.94, 73.65). The subgroup analysis based on regional state revealed that the pooled prevalence of common mental disorders in Amhara, Oromia, and the other two regions (Addis Ababa and SNNPR) was 72.4, 50.23, and 54.25%, respectively. History of mental illness (AOR = 6.21, 95% CI: 3.27, 11.80), poor social support (AOR = 3.90, 95% CI: 1.45, 10.51), and traumatic life events (AOR = 3.63, 95% CI: 1.04, 12.73) were significantly associated with a common mental disorder in this review.ConclusionIn this systematic review and meta-analysis, the pooled prevalence of common mental disorders among prisoners was high. Therefore, improving the delivery of mental health services in correctional institutions has a major contribution to the reduction of the disorder, and incarcerated people require more attention and early intervention for common mental disorders.

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A Systematic Review and Meta-Analysis of Measurement Feedback Systems in Treatment for Common Mental Health Disorders.

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A Systematic Review and Meta-Analysis of Measurement Feedback Systems in Treatment for Common Mental Health Disorders.

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