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Illness burden and physical outcomes associated with collaborative care in patients with comorbid depressive disorder in chronic medical conditions: a systematic review and meta-analysis

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van Eck van der Sluijs, Jonna F., Castelijns, Hilde, Eijsbroek, Vera, Rijnders, Cees A. Th., van Marwijk, Harm W.J., van der Feltz-Cornelis, Christina M.·2018·General Hospital Psychiatry
DOI 10.1016/j.genhosppsych.2017.08.003
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Abstract

Objective Collaborative care (CC) improves depressive symptoms in people with comorbid depressive disorder in chronic medical conditions, but its effect on physical symptoms has not yet systematically been reviewed. This study aims to do so.Methods Systematic review and meta-analysis was conducted using PubMed, the Cochrane Library, and the European and US Clinical Trial Registers. Eligible studies included randomized controlled trials (RCTs) of CC compared to care as usual (CAU), in primary care and general hospital setting, reporting on physical and depressive symptoms as outcomes. Overall treatment effects were estimated for illness burden, physical outcomes and depression, respectively.Results Twenty RCTs were included, with N=4774 patients. The overall effect size of CC versus CAU for illness burden was OR 1.64 (95%CI 1.47;1.83), d=0.27 (95%CI 0.21;0.33). Best physical outcomes in CC were found for hypertension with comorbiddepression. Overall, depression outcomes were better for CC than for CAU. Moderator analyses did not yield statistically significant differences.Conclusions CC is more effective than CAU in terms of illness burden, physical outcomes and depression, in patients with comorbid depression in chronic medical conditions. More research covering multiple medical conditions is needed.Protocol registration number The protocol for this systematic review and meta-analysis has been registered at the International Prospective Register of Systematic Reviews (PROSPERO) on February 19th 2016: http://www.crd.york.ac.uk/PROSPERO/DisplayPDF.php?ID=CRD42016035553.

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  • Their effect on physical health varies depending on the specific condition.

    “Their effect on physical health, however, varies depending on the specific condition292,369.”

    From Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management (2023) · cites this paper as [369]

    Section 3.5.2 reports an overall benefit of collaborative care on combined physical outcomes across chronic conditions. But the paper reports that moderator analyses found no statistically significant differences, so it does not establish that the effect varies by specific condition. The supplied Table 1 passage lists different outcomes measured for different conditions, not differences in effect. (LLM, conf=0.78)

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  • The failure to publish negative trial results leads to overestimating effect sizes in meta-analyses.

    “The failure to publish negative trial results, as demonstrated for drug trials 580 and psychotherapy trials, 581 leads to overestimating effect sizes in meta-analyses.”

    From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [581]

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1 of the 96 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. [50][50] Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in metaanalyses. BMJ 2003;327(7414):557-60. -
  2. [52][52] Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to meta-analysis (statistics in practice) . Chichester (UK): Wiley & Sons; 2009. -
  3. [75][75] Katon W, Russo J, Lin EH, Schmittdiel J, Ciechanowski P, Ludman E, et al. Costeffectiveness of a multicondition collaborative care intervention: A randomized controlled trial. Arch Gen Psychiatry 2012;69(5):506-14. -

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Authors
van Eck van der Sluijs, J. F., Castelijns, H., Eijsbroek, V., Rijnders, C. A. T., van Marwijk, H. W. J., & van der Feltz-Cornelis, C. M.
Affiliations
  • Parnassia Groep (NL)
  • GGz Breburg (NL)
Venue
General Hospital Psychiatry
Publisher
Elsevier BV
Published
2018-01
Volume
50
Pages
1-14
ISSN
0163-8343 (ISSN-L)
DOI
10.1016/j.genhosppsych.2017.08.003
OpenAlex
W2754481489
Cited by
59
References
96
Citations by year
2026: 3 · 2025: 4 · 2024: 4 · 2023: 18 · 2022: 6 · 2021: 5 · 2020: 13 · 2019: 2 · 2018: 3 · 2017: 1
FWCI
0.80
Type
journal article
Language
en
Open access
Licence
Locations
  • General Hospital Psychiatry (publishedVersion)
  • Research portal (Tilburg University) (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, cc-by)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
  • Research Explorer (The University of Manchester) (publishedVersion, other-oa)
  • Sussex Research Online (University of Sussex) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords
collaborative care, comorbid depression, chronic disease, disease burden, somatic symptoms, hypertension, primary care, general hospital care, usual care, depression treatment
MeSH terms
Chronic Disease, Depressive Disorder, Humans, Hypertension, Patient Care Team, Psychotherapy, Comorbidity, Outcome Assessment, Health Care, Cost of Illness

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