Journal
JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE
Volume 31, Issue 1, Pages 139-150Publisher
AMER BOARD FAMILY MEDICINE
DOI: 10.3122/jabfm.2018.01.170270
Keywords
Anxiety Disorders; Depressive Disorder; Mental Health; Primary Health Care; Problem Solving; Psychotherapy
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Background: There is increasing demand for managing depressive and/or anxiety disorders among primary care patients. Problem-solving therapy (PST) is a brief evidence-and strength-based psychotherapy that has received increasing support for its effectiveness in managing depression and anxiety among primary care patients. Methods: We conducted a systematic review and meta-analysis of clinical trials examining PST for patients with depression and/or anxiety in primary care as identified by searches for published literature across 6 databases and manual searching. A weighted average of treatment effect size estimates per study was used for meta-analysis and moderator analysis. Results: From an initial pool of 153 primary studies, 11 studies (with 2072 participants) met inclusion criteria for synthesis. PST reported an overall significant treatment effect for primary care depression and/or anxiety (d = 0.673; P <.001). Participants' age and sex moderated treatment effects. Physician-involved PST in primary care, despite a significantly smaller treatment effect size than mental health provider only PST, reported an overall statistically significant effect (d = 0.35; P = .029). Conclusions: Results from the study supported PST's effectiveness for primary care depression and/or anxiety. Our preliminary results also indicated that physician-involved PST offers meaningful improvements for primary care patients' depression and/or anxiety.
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