CG123 Common mental health disorders - National Institute for ...

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Further assessment of risk and need for treatment, and routine outcome monitoringComponentReview questionObjectivesPopulationIntervention(s)ComparisonCritical outcomesElectronic databasesDescriptionIn adults (18 years and older) identified with depression(including subthreshold disorders) or an anxiety disorder*,should ROM be used, and if so, what systems areeffective for the delivery of ROM and use within clinicaldecision making?To perform a narrative synthesis of systematic reviewsaddressing the use of ROM for people with a commonmental health disorderAdults (18 years and older) identified with depression(including subthreshold disorders) or an anxiety disorder*ROM, systems for the delivery of ROMStandard management strategyCommon mental health disorder symptoms, duration oftreatmentSystematic reviews: CDSR, CINAHL, DARE, EMBASE,MEDLINE, PsycINFORCTs: CENTRALDate searched Systematic reviews: 1 January 1995 to 10 September 2010RCTs: 1 January 2008 up to 10 September 2010Study designTable 38: Clinical review protocol for the review of ROMSystematic review and RCTs*Including GAD, panic disorder, social anxiety disorder, OCD, specific phobias and PTSD.(SHIMOKAWA2010 [Shimokawa et al., 2010]). Therefore, only the more recentreview was included in this chapter. KNAUP2009 assessed the impact of routine feedbackto both healthcare professionals and service users on mental health outcomes inspecialist mental health services. SHIMOKAWA2010 focused specifically on ROMfor service users who showed a poor initial response to treatment. Given thatKNAUP2009 conducted their search in 2008, the search for this guideline wasconducted for RCTs published between January 2008 and September 2010. Thesearch resulted in 2,402 articles. Scanning titles/abstracts identified no potentiallyrelevant trials that were not already included in the existing reviews.The characteristics of the reviews included in this section can be found in Table39. Further information about both included and excluded studies can be found inAppendix 14.183
Further assessment of risk and need for treatment, and routine outcome monitoringTable 39: Study information table for systematic reviews of ROMStudy ID KNAUP2009 SHIMOKAWA2010Type of ROM General Therapist signal alarm feedbackOutcome of ROM Mental health outcome Improvement/worsening ofsymptomsMethod used to Meta-analysis Meta-analysissynthesise evidenceDesign of included Controlled trials using RCT and quasi-experimentalstudiesoutcome managementDates searched Inception to 2008 Not applicableDiagnosis Common mental health Common mental healthdisorder (some studies disorderincluded people withpersonality disorders,eating disorders orschizophrenia)No. of included 12 6studiesReview quality Moderate risk of bias Moderate risk of bias(quality of included studies (this study did not claim to benot assessed/reported) a systematic review, but ratherwas a meta-analysis of sixmajor studies using theOutcome Questionnaire-45)6.4.4 Clinical evidenceKNAUP2009 reviewed a total of 12 studies to assess the effectiveness of ROM. Thereview focused on ROM methods, the effect of ROM on short-term mental healthoutcomes, long-term mental health outcomes and length of treatment, and finally onmoderator variables influencing the effect of ROM on short-term mental healthoutcomes. SHIMOKAWA2010 meta-analysed six controlled studies to investigate theeffects of ROM, specifically signal-alarm feedback, on treatment outcome and attendancerates. It is important to note that this study was a meta-analysis of studies previouslyconducted by the same research group and is not a systematic review. It hasbeen included here due to lack of available evidence in the area. The results of the tworeviews are discussed in more detail below.184
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Commonmental healthdisordersTHE NIC
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© The British Psychological Societ
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Contents6 FURTHER ASSESSMENT OF RIS
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Guideline development group members
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Preface1 PREFACEThis guideline has
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Prefacecollaborative manner using t
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PrefaceThe experience of people wit
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Common mental health disorders2.2 T
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Common mental health disordersto ho
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Common mental health disordersManua
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Common mental health disordershighe
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Common mental health disordersNegat
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Common mental health disorderscours
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Common mental health disordersover
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Common mental health disorders2.2.6
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Common mental health disordersTable
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Common mental health disorders1996)
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Common mental health disordersSumma
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Common mental health disordersTable
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Common mental health disordersappli
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Common mental health disorderspatie
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Methods used to develop this guidel
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Access to healthcare4. ACCESS TO HE
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Access to healthcareunder the Menta
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Access to healthcare4.2.3 Studies c
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Access to healthcareIndividual-leve
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Access to healthcareJUNG2003 review
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Access to healthcareSCHEPPERS2006).
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Access to healthcare70Table 8: Clin
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Access to healthcareTable 9: Study
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Access to healthcareCHAPMAN2004 inc
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Access to healthcare4.4 SERVICE DEV
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Access to healthcareBEACH2006 [Beac
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Access to healthcareTable 12: Summa
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Access to healthcareAll studies wer
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Access to healthcarepractitioners h
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Access to healthcareIndividual-leve
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Access to healthcarefrom such popul
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Access to healthcarestructure and d
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Case identification and formal asse
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Page 231 and 232: Appendices9 APPENDICESAppendix 1: S
Page 233 and 234: Appendix 1of a depressive disorder
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Appendix 1b) Assessment of anxiety
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Appendix 2APPENDIX 2:DECLARATIONS O
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Appendix 2Mr Mike BessantEmployment
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Appendix 2Personal non-pecuniary in
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Appendix 2Actions takenMr Rupert Su
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Appendix 2Personal family interestN
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Appendix 3APPENDIX 3:STAKEHOLDERS A
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Appendix 4ClinicalpopulationPeople
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Appendix 4Case identificationNo. Pr
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Appendix 5APPENDIX 5:REVIEW PROTOCO
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Appendix 7APPENDIX 7:METHODOLOGY CH
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Appendix 9APPENDIX 9:METHODOLOGY CH
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Appendix 92.10 Are all important pa
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Appendix 9case also excludes costs
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Appendix 9For consistency, the EQ-5
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Appendix 9Answer ‘yes’ if the a
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Appendix 9Answer ‘yes’ if the e
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Appendix 9Answer ‘yes’ if appro
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Appendix 10APPENDIX 10: EVIDENCE TA
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Appendix 11APPENDIX 11:HIGH PRIORIT
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Appendix 11discussion of options bu
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Appendix 13APPENDIX 13:GENERALIZED
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ReferencesAndlin-Sobocki, P., Jöns
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ReferencesBower, P., Gilbody, S., R
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ReferencesCooper, S., Smiley, E., M
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ReferencesEhlers A., Gene-Cos N. &
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ReferencesGiles, D. E., Jarrett, R.
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ReferencesHorowitz, M. J., Wilner,
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ReferencesKnapp, M. & Ilson, S. (20
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ReferencesMarks, J., Goldberg, D. P
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ReferencesNCCMH (forthcoming) Self-
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ReferencesOzer, E. J., Best, S. R.,
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ReferencesSartorius, N. (2002) Eine
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ReferencesTiemens, B. G., Ormel, J.
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ReferencesWilkinson, M. J. B. & Bar
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Glossarybeliefs and interpretations
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Glossaryto learn to become more awa
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Abbreviations12 ABBREVIATIONSADDADS
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AbbreviationsOASISOCDONSORPHQ (-A,
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