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Review: collaborative care improves depression and anxiety symptoms in adults

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Question

Question: How effective is collaborative care for anxiety and depression?

Outcomes: Changes in depression or anxiety assessed by self-reported or clinician-rated instruments. Outcomes were classified as short-term (0–6 months), medium term (7–12 months), long term (13–24 months) and very long term (25 months or longer). Where possible, response outcomes were reported (ie, ≥50% reduction in symptom scores from baseline), in preference to remission outcomes (scoring under a specified threshold).

Methods

Design: Systematic review with meta-analysis.

Data sources: Cochrane Collaboration Depression, Anxiety and Neurosis Group (CCDAN) clinical trials registers were searched from inception to February 2012 for randomised controlled trials (RCTs). CINAHL was searched from inception to November 2010 for RCTs. Reference lists of identified studies were hand searched.

Study selection and analysis: Two reviewers appraised studies and selected RCTs of collaborative care in people with depression or anxiety (all ages included; Diagnostic and Statistical Manual (DSM), International Classification of Diseases (ICD) or Research Diagnostic Criteria). Collaborative care had to include a structured management plan (using guidelines or protocols and including pharmacological or non-pharmacological interventions, …

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