See the published version of this preprint at International Journal of Mental Health Systems.
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Syed Usman Hamdani
University of Liverpool Institute of Psychology Health and Society
Corresponding Author
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Background: In many low resource settings, the provision of government mental health care services is limited to specialized psychiatry units in urban hospital care facilities, where the most common treatment for common mental disorders (CMDs) is pharmacotherapy, occasionally with adjunct nonspecific psychological support. We aimed to evaluate the effectiveness of adding a low intensity, psychological intervention, Problem Management Plus (PM+) for CMDs into routine care in a specialized mental health care facility in Pakistan.
Methods: A two arm, single-blind individual randomized controlled trial (RCT) was carried out with adults (N=192), referred for psychological support by psychiatrists. The study participants were randomized (1:1) to PM+ plus Treatment as Usual (TAU) (n = 96) or TAU only (n = 96). The primary outcomes were symptoms of anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS) and functional impairment as measured by WHO Disability Assessment Schedule (WHODAS 2.0) at 20 weeks after baseline.
Results: The analysis was done on intention-to-treat principle. The linear mixed model analysis showed that at 20 weeks after baseline, there was a significant reduction in symptoms of anxiety and depression (mean [SD], 16.23 [8.81] vs 19.79 [7.77]; AMD, -3.10; 95% CI, −0.26 to −5.76); p=0.03 and improvement in functioning (mean [SD], 22.94 [9.37] vs 27.37 [8.36]; AMD, -4.35; 95% CI, -1.45 to -7.24); p=0.004 in PM+ plus TAU versus TAU arm. The follow-up rate was 67% at primary end-point.
Conclusions: Specialized care facilities in LMICs may consider adding brief, evidence-based psychological treatments for CMDs to their routine care.
Keywords
Low intensity psychological intervention, Cognitive Behavioral Therapy, Specialized mental health facility, Common Mental Disorders, Depression, Anxiety
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CURRENT STATUS: Published
View the published article at International Journal of Mental Health Systems.
Version 3
Posted 07 Jan, 2021
No community comments so far
Editorial decision: Accept
On 28 Dec, 2020
Editor assigned
On 23 Dec, 2020
Submission checks complete
On 23 Dec, 2020
Editor invited
On 23 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 10 Dec, 2020
Editor assigned
On 06 Dec, 2020
Submission checks complete
On 06 Dec, 2020
Editor invited
On 06 Dec, 2020
No comments provided
Review #2 received
Received 07 Nov, 2020
Editorial decision: Major revision
On 07 Nov, 2020
Reviewer #2 agreed
On 11 Aug, 2020
Review #1 received
Received 30 May, 2020
Reviewer #1 agreed
On 11 May, 2020
Reviewers invited
Invitations sent on 06 May, 2020
Editor assigned
On 04 May, 2020
Editor invited
On 03 May, 2020
Submission checks complete
On 02 May, 2020
First submitted
On 30 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at International Journal of Mental Health Systems.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Syed Usman Hamdani
University of Liverpool Institute of Psychology Health and Society
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at International Journal of Mental Health Systems.
Version 3
Posted 07 Jan, 2021
No community comments so far
Editorial decision: Accept
On 28 Dec, 2020
Editor assigned
On 23 Dec, 2020
Submission checks complete
On 23 Dec, 2020
Editor invited
On 23 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 10 Dec, 2020
Editor assigned
On 06 Dec, 2020
Submission checks complete
On 06 Dec, 2020
Editor invited
On 06 Dec, 2020
No comments provided
Review #2 received
Received 07 Nov, 2020
Editorial decision: Major revision
On 07 Nov, 2020
Reviewer #2 agreed
On 11 Aug, 2020
Review #1 received
Received 30 May, 2020
Reviewer #1 agreed
On 11 May, 2020
Reviewers invited
Invitations sent on 06 May, 2020
Editor assigned
On 04 May, 2020
Editor invited
On 03 May, 2020
Submission checks complete
On 02 May, 2020
First submitted
On 30 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at International Journal of Mental Health Systems.
Background: In many low resource settings, the provision of government mental health care services is limited to specialized psychiatry units in urban hospital care facilities, where the most common treatment for common mental disorders (CMDs) is pharmacotherapy, occasionally with adjunct nonspecific psychological support. We aimed to evaluate the effectiveness of adding a low intensity, psychological intervention, Problem Management Plus (PM+) for CMDs into routine care in a specialized mental health care facility in Pakistan.
Methods: A two arm, single-blind individual randomized controlled trial (RCT) was carried out with adults (N=192), referred for psychological support by psychiatrists. The study participants were randomized (1:1) to PM+ plus Treatment as Usual (TAU) (n = 96) or TAU only (n = 96). The primary outcomes were symptoms of anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS) and functional impairment as measured by WHO Disability Assessment Schedule (WHODAS 2.0) at 20 weeks after baseline.
Results: The analysis was done on intention-to-treat principle. The linear mixed model analysis showed that at 20 weeks after baseline, there was a significant reduction in symptoms of anxiety and depression (mean [SD], 16.23 [8.81] vs 19.79 [7.77]; AMD, -3.10; 95% CI, −0.26 to −5.76); p=0.03 and improvement in functioning (mean [SD], 22.94 [9.37] vs 27.37 [8.36]; AMD, -4.35; 95% CI, -1.45 to -7.24); p=0.004 in PM+ plus TAU versus TAU arm. The follow-up rate was 67% at primary end-point.
Conclusions: Specialized care facilities in LMICs may consider adding brief, evidence-based psychological treatments for CMDs to their routine care.
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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