Division of Mental and Physical Health, Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaes gate 7, 5015, Bergen, Norway.
Centre for Evaluation of Public Health Measure, Norwegian Institute of Public Health, Bergen, Norway.
BMC Psychiatry. 2022 Sep 9;22(1):598. doi: 10.1186/s12888-022-04227-0.
Whether long-term symptom improvement is maintained after treatment in services such as the Norwegian Prompt Mental Health Care (PMHC) and the English Improving Access to Psychological Therapies is not yet known. In this prospective study, we investigate whether improvements observed at 6-month follow-up are maintained at 24- and 36-month follow-up among clients who received PMHC.
Data from the treatment arm of the randomized controlled trial of PMHC were used (n = 459). The main outcomes were (reliable) recovery rate and symptoms of depression (PHQ-9) and anxiety (GAD-7). Primary outcome data at 24- and 36-months follow-up were available for 47% and 39% of participants, respectively. Secondary outcomes were work participation, functional status, health-related quality of life, and positive mental well-being. Sensitivity analyses with regard to missing data assumptions were conducted for the primary continuous outcomes.
Improvements were maintained at 24- and 36-month follow-up for symptoms of depression and anxiety, (reliable) recovery rate, and health-related quality of life. Small linear improvements since 6-month follow-up were observed for work participation, functional status, and positive mental well-being. Sensitivity analyses did not substantially alter the findings for symptoms of depression and anxiety mentioned above.
Our findings support the long-term effectiveness of PMHC, but results should be interpreted with caution due to lacking follow-up data at 24- and 36-month in the control group, and substantial attrition.
在挪威快速心理保健服务（PMHC）和英国改善心理治疗服务等机构中接受治疗后，长期症状改善是否能持续，目前尚不清楚。在这项前瞻性研究中，我们调查了接受 PMHC 治疗的患者在 6 个月随访时观察到的改善是否能持续到 24 个月和 36 个月随访时。
使用了 PMHC 随机对照试验治疗组的数据（n=459）。主要结局是（可靠）恢复率以及抑郁症状（PHQ-9）和焦虑症状（GAD-7）。分别有 47%和 39%的参与者在 24 个月和 36 个月随访时提供了主要结局数据。次要结局是工作参与度、功能状态、健康相关生活质量和积极的心理幸福感。对主要连续结局的缺失数据假设进行了敏感性分析。
抑郁和焦虑症状、（可靠）恢复率和健康相关生活质量在 24 个月和 36 个月随访时都得到了维持。自 6 个月随访以来，工作参与度、功能状态和积极的心理幸福感呈现出较小的线性改善。敏感性分析并未对上述抑郁和焦虑症状的发现产生实质性影响。
我们的研究结果支持 PMHC 的长期有效性，但由于对照组在 24 个月和 36 个月时缺少随访数据，以及大量的参与者流失，结果应谨慎解释。
