UCL logo

UCL Discovery

UCL home » Library Services » Electronic resources » UCL Discovery

Trajectories of depression and anxiety symptom change during psychological therapy

Saunders, R; Buckman, JEJ; Cape, J; Fearon, P; Leibowitz, J; Pilling, S; (2019) Trajectories of depression and anxiety symptom change during psychological therapy. Journal of Affective Disorders , 249 pp. 327-335. 10.1016/j.jad.2019.02.043. Green open access

[img]
Preview
Text
1-s2.0-S0165032718324443-main.pdf - ["content_typename_Published version" not defined]

Download (697kB) | Preview

Abstract

BACKGROUND: Forty-percent of the variance in psychological treatment outcomes is estimated to be explained by symptom change by the third treatment session. However, change may not be uniform across patient groups and symptom domains. This study aimed to identify subgroups of patients with different trajectories of depression and anxiety symptom change during psychological therapy and identify baseline patient characteristics associated with these trajectories. METHODS: 4394 patients attending two psychological treatment services completed sessional, self-report depression and anxiety measures. Trajectories of symptom change were investigated using latent class growth analysis. Multinomial logistic regression was used to explore associations between baseline patient characteristics and trajectory classes. RESULTS: A number of distinct trajectories were identified. Anxiety symptom trajectories could be distinguished by the third treatment session, but for depression symptoms there was a class displaying limited change until session six followed by rapid improvement in symptoms thereafter. Compared to the non-responding trajectories, depression and anxiety trajectories indicating treatment response were associated with lower baseline severity, better social functioning and lower incidence of phobic anxiety, but not with medication prescription status. LIMITATIONS: Data came from two services, so wider generalisability is unknown. Predictors were limited to data routinely collected in the services; unmeasured factors may have improved the prediction of trajectories. CONCLUSIONS: Baseline characteristics and symptom change early in therapy can help identify different trajectories of symptom change. This knowledge could aid clinical decision making and help improve treatment outcomes. By ignoring distinct trajectories, clinicians may incorrectly consider patients as "not-on-track" and unnecessarily change or end therapy that would otherwise benefit patients.

Type: Article
Title: Trajectories of depression and anxiety symptom change during psychological therapy
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jad.2019.02.043
Publisher version: https://doi.org/10.1016/j.jad.2019.02.043
Language: English
Additional information: © 2019 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/BY/4.0/).
Keywords: Anxiety, Depression, IAPT, Latent class growth analysis, Psychotherapy
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: http://discovery.ucl.ac.uk/id/eprint/10069401
Downloads since deposit
50Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item