This article is more than 5 years old. Information may no longer be current.

Psychological therapy plus feedback technology cuts depression, anxiety symptom severity

Supplementing psychological therapy with low-cost, web-based feedback technology that enables clinicians to monitor how patients with depression cope can decrease symptom severity in patients who may not respond well to treatment, according to research findings.

“Depression…is a leading cause of disability world-wide, it increases the risk of suicide, it can deteriorate the course of other health problems and it carries enormous costs to the society in health care and welfare expenses,” Jaime Delgadillo, PhD, from the clinical psychology unit, University of Sheffield, England, told Healio Psychiatry.

“Psychological interventions like cognitive behavioral therapy are known to be helpful, but not every patient responds well to therapy,” he continued. “At least 30% of patients do not experience reliable improvement in their symptoms after psychological care, and up to 10% of patients actually deteriorate during treatment. Therefore, finding ways to improve the effects of treatment and to prevent deterioration are important challenges for the mental health field.”

Researchers conducted a multisite, cluster randomized controlled trial at eight National Health Service Trusts in England to determine the effectiveness of an outcome feedback quality assurance system utilized in stepped care psychological services.

Therapists who were qualified to deliver both low- and high-intensity psychological interventions were randomly assigned (1:1) — using computer generated randomization — to an outcome feedback intervention group, or a treatment-as-usual control group.

Participants received low-intensity — less than eight sessions — or high-intensity — up to 20 sessions — psychological therapies during the 1-year study period. A computerized algorithm alerted therapists in the outcome feedback group when participants were not on track and prepared them to review these patients in clinical supervision. The authors compared symptom severity on depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7) measures after treatment at different times during the study period between groups.

Of 77 therapists included in this study, 39 were assigned to the outcome feedback group and 38 to the control group. Of 2,233 patients included in the study, 1,176 (53%) were treated by therapists in the outcome feedback group and 1,057 (47%) by those in the control group.

The results showed that participants assigned to the outcome feedback group who were classified as not on track during their psychological therapy had less severe symptoms of depression (B = –1.03; 95% CI, –1.84 to –0.23) and anxiety (B = – 0.85; 95% CI, –1.56 to –0.14) after treatment than those in the control group. Furthermore, patients in the control group were more likely to deteriorate than patients in the outcome feedback group, according to the study findings. Delgadillo and colleagues also reported no significant effects of outcome feedback technology on treatment duration.

“Routinely monitoring the symptoms of patients during treatment, using validated symptom measures and feedback technology, can improve the effectiveness of psychological care,” Delgadillo told Healio Psychiatry. – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.