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Is social support pre‐treatment associated with prognosis for adults with depression in primary care?

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Title: Is social support pre‐treatment associated with prognosis for adults with depression in primary care?
Authors: Buckman, Joshua E. J. (AUTHOR), Saunders, Rob (AUTHOR), O'Driscoll, Ciaran (AUTHOR), Cohen, Zachary D. (AUTHOR), Stott, Joshua (AUTHOR), Ambler, Gareth (AUTHOR), Gilbody, Simon (AUTHOR), Hollon, Steven D. (AUTHOR), Kendrick, Tony (AUTHOR), Watkins, Edward (AUTHOR), Wiles, Nicola (AUTHOR), Kessler, David (AUTHOR), Chari, Nomsa (AUTHOR), White, Ian R. (AUTHOR), Lewis, Glyn (AUTHOR), Pilling, Stephen (AUTHOR)
Source: Acta Psychiatrica Scandinavica. May2021, Vol. 143 Issue 5, p392-405. 14p. 1 Diagram, 6 Charts.
Subjects: Social support, Prognosis, Primary care, Panic disorders, Mental depression
Abstract: Objective: Depressed patients rate social support as important for prognosis, but evidence for a prognostic effect is lacking. We aimed to test the association between social support and prognosis independent of treatment type, and the severity of depression, and other clinical features indicating a more severe illness. Methods: Individual patient data were collated from all six eligible RCTs (n = 2858) of adults seeking treatment for depression in primary care. Participants were randomized to any treatment and completed the same baseline assessment of social support and clinical severity factors. Two‐stage random effects meta‐analyses were conducted. Results: Social support was associated with prognosis independent of randomized treatment but effects were smaller when adjusting for depressive symptoms and durations of depression and anxiety, history of antidepressant treatment, and comorbid panic disorder: percentage decrease in depressive symptoms at 3–4 months per z‐score increase in social support = −4.14(95%CI: −6.91 to −1.29). Those with a severe lack of social support had considerably worse prognoses than those with no lack of social support: increase in depressive symptoms at 3–4 months = 14.64%(4.25% to 26.06%). Conclusions: Overall, large differences in social support pre‐treatment were associated with differences in prognostic outcomes. Adding the Social Support scale to clinical assessments may be informative, but after adjusting for routinely assessed clinical prognostic factors the differences in prognosis are unlikely to be of a clinically important magnitude. Future studies might investigate more intensive treatments and more regular clinical reviews to mitigate risks of poor prognosis for those reporting a severe lack of social support. [ABSTRACT FROM AUTHOR]
Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Is social support pre‐treatment associated with prognosis for adults with depression in primary care?
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  Data: <searchLink fieldCode="AR" term="%22Buckman%2C+Joshua+E%2E+J%2E%22">Buckman, Joshua E. J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Saunders%2C+Rob%22">Saunders, Rob</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22O'Driscoll%2C+Ciaran%22">O'Driscoll, Ciaran</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cohen%2C+Zachary+D%2E%22">Cohen, Zachary D.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stott%2C+Joshua%22">Stott, Joshua</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ambler%2C+Gareth%22">Ambler, Gareth</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gilbody%2C+Simon%22">Gilbody, Simon</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hollon%2C+Steven+D%2E%22">Hollon, Steven D.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kendrick%2C+Tony%22">Kendrick, Tony</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Watkins%2C+Edward%22">Watkins, Edward</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wiles%2C+Nicola%22">Wiles, Nicola</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kessler%2C+David%22">Kessler, David</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Chari%2C+Nomsa%22">Chari, Nomsa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22White%2C+Ian+R%2E%22">White, Ian R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lewis%2C+Glyn%22">Lewis, Glyn</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pilling%2C+Stephen%22">Pilling, Stephen</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Acta+Psychiatrica+Scandinavica%22">Acta Psychiatrica Scandinavica</searchLink>. May2021, Vol. 143 Issue 5, p392-405. 14p. 1 Diagram, 6 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Social+support%22">Social support</searchLink><br /><searchLink fieldCode="DE" term="%22Prognosis%22">Prognosis</searchLink><br /><searchLink fieldCode="DE" term="%22Primary+care%22">Primary care</searchLink><br /><searchLink fieldCode="DE" term="%22Panic+disorders%22">Panic disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink>
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  Data: Objective: Depressed patients rate social support as important for prognosis, but evidence for a prognostic effect is lacking. We aimed to test the association between social support and prognosis independent of treatment type, and the severity of depression, and other clinical features indicating a more severe illness. Methods: Individual patient data were collated from all six eligible RCTs (n = 2858) of adults seeking treatment for depression in primary care. Participants were randomized to any treatment and completed the same baseline assessment of social support and clinical severity factors. Two‐stage random effects meta‐analyses were conducted. Results: Social support was associated with prognosis independent of randomized treatment but effects were smaller when adjusting for depressive symptoms and durations of depression and anxiety, history of antidepressant treatment, and comorbid panic disorder: percentage decrease in depressive symptoms at 3–4 months per z‐score increase in social support = −4.14(95%CI: −6.91 to −1.29). Those with a severe lack of social support had considerably worse prognoses than those with no lack of social support: increase in depressive symptoms at 3–4 months = 14.64%(4.25% to 26.06%). Conclusions: Overall, large differences in social support pre‐treatment were associated with differences in prognostic outcomes. Adding the Social Support scale to clinical assessments may be informative, but after adjusting for routinely assessed clinical prognostic factors the differences in prognosis are unlikely to be of a clinically important magnitude. Future studies might investigate more intensive treatments and more regular clinical reviews to mitigate risks of poor prognosis for those reporting a severe lack of social support. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/acps.13285
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        Text: English
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      – SubjectFull: Social support
        Type: general
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      – SubjectFull: Primary care
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