Karyotaki2022 - Association of Task-Shared Psychological Interventions With Depression Outcomes in Low- and Middle-Income Countries, A Systematic Review and Individual Patient Data Meta-analysis
- Type:#article
- Year read:#read2022
- Subject: Depression
- Bibtex: @karyotaki2022
- Bibliography: Karyotaki E, Araya R, Kessler RC, Waqas A, Bhana A, Rahman A, et al. Association of Task-Shared Psychological Interventions With Depression Outcomes in Low- and Middle-Income Countries: A Systematic Review and Individual Patient Data Meta-analysis. JAMA Psychiatry. 2022 May 1;79(5):430.
Example citation
Key takeaways
- k = 11, n = 4145 participants
- Studies in India, Nepal, Zimbabwe, South Africa, Uganda, Brazil, Pakistan
- g = 0.32 (95% CI 0.26 to 0.38)
- Task-sharing means trt by non-specialists
Results
Of 13 eligible trials, 11 (4145 participants) contributed IPD. Task-shared psychological interventions were associated with a greater decrease in depressive symptom severity than control conditions (Hedges g, 0.32; 95% CI, –0.26 to –0.38). Participants in the intervention groups had a higher chance of responding (odds ratio, 2.11; 95% CI, 1.60 to 2.80) and remitting (odds ratio, 1.87; 95% CI, 1.20 to 1.99). The presence of psychomotor symptoms was significantly associated with the outcomes of task-shared psychological interventions (β [SE], –1.21 [0.39]; P = .002). No other significant associations were identified. Heterogeneity among the trials with IPD was 74% (95% CI, 53%-86%).
Conclusions
In this meta-analysis of IPD, task-shared psychological interventions were associated with a larger reduction in depressive symptom severity and a greater chance of response and remission than control conditions. These findings show potential for the use of task-sharing of psychological interventions across different groups of patients with depression. Further research would help identify which people are most likely to benefit and strengthen larger-scale implementation of this strategy to address the burden of depression in LMICs.