Latest news with #TalkingTherapies
Medscape
4 days ago
- Health
- Medscape
Talk Therapy Less Effective in Young vs Middle-Aged Adults
TOPLINE: NHS Talking Therapies for anxiety and depression (TTad) were less effective for adults aged 16-24 years than for those aged 25-65 years, a cohort study of over 1.5 million people revealed. METHODOLOGY: Researchers conducted a retrospective cohort study using the data of 309,758 young adults (aged 16-24 years; 69.4% women; 82.5% White) and 1,290,130 working-age adults (aged 25-65 years; 65.2% women; 83.6% White) who received psychological treatment through England's NHS TTad services between 2015 and 2019. The primary outcome was the change in symptom severity scores on the Patient Health Questionnaire nine-item (PHQ-9) and Generalised Anxiety Disorder Scale seven-item (GAD-7) between age groups. Secondary outcomes were rates of recovery, reliable recovery, reliable improvement, and reliable deterioration. The analysis was adjusted for gender, ethnicity, local area deprivation, clinical factors, treatment intensity, and the number of sessions. Sensitivity analyses included geographical and temporal variation in age-related differences and adults older than 65 years in the working-age group. TAKEAWAY: Differences in pre-post symptom severity scores on the PHQ-9 and GAD-7 increased with age. In the unadjusted analysis, young adults experienced smaller improvements in PHQ-9 and GAD-7 scores than working-age adults (PHQ-9: b, -0.98; GAD-7: b, -0.77; P < .001 for both). The magnitude of difference was smaller in the adjusted analysis. Young adults had lower rates of reliable recovery (41.5% vs 48.2%; adjusted odds ratio [aOR], 0.76), reliable improvement (68.6% vs 72.6%; aOR, 0.83), and recovery (43.7% vs 51.1%; aOR, 0.74) but higher rates of reliable deterioration (5.9% vs 5.2%; aOR, 1.15) than working-age adults. Age-related differences were consistent across regions and treatment years, with London having the smallest difference (3.0%) and the South West having the largest difference (~6.5%), and unchanged when including adults older than 65 years. IN PRACTICE: "Getting young adults into treatment more quickly, offering them treatment in a convenient and desired format, and working hard to ensure they stay in treatment have the potential to improve outcomes for this group. Addressing social factors that are of particular concern to emerging adults — eg, job and housing insecurity — might also be required to improve outcomes in young adults," the authors wrote. "Considering and trialling adaptions tailored to specific requirements of this age group, the management of information on mental health and mental illness, as well as expectations of treatment, might also be necessary," they added. SOURCE: This study was led by Rob Saunders, PhD, and Jae Won Suh, DPhil, University College London, London, England. It was published online on August 6 in The Lancet Psychiatry. LIMITATIONS: The use of routinely recorded health service data limited the availability of measures on general well-being and personal sense of improvement. Although the analysis was adjusted for neurodevelopmental conditions such as autism, attention-deficit/hyperactivity disorder, and intellectual disability, the severity of these conditions and other potential confounders, such as gender identity, sexual orientation, and social support, were not captured. Moreover, unmeasured differences in treatment delivery and other common disorders in young adults may have influenced the results, and the findings were not generalisable to non-binary individuals due to limited data availability. DISCLOSURES: This study was funded by the UK National Institute for Health and Care Research. The authors reported having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
19-06-2025
- Health
- Medscape
Early Talk Therapy After Stroke Tied to Better Psych Outcome
Psychological therapy was associated with significantly reduced symptoms of depression and anxiety among patients with a history of stroke, with greater benefits in those who initiated talk therapy within 6 months of the stroke compared to those who began treatment later, new research showed. METHODOLOGY: Researchers analyzed data from more than 7000 adults with a hospital diagnosis of stroke. All had undergone at least two sessions of poststroke psychological treatment through the National Health Service Talking Therapies program for anxiety and depression in England between 2012 and 2019. Primary outcomes included 'reliable improvement,' defined as a 6-point or greater reduction on the 9-item Patient Health Questionnaire (PHQ-9) or a 4-point or greater reduction on the 7-item Generalized Anxiety Disorder scale (GAD-7); 'reliable recovery,' which included improvement along with scores below 10 on the PHQ-9 and scores below 8 on the GAD-7; and 'reliable deterioration,' defined as at least a 6-point increase on PHQ-9 or at least a 4-point increase on GAD-7. Secondary outcomes included pre- to posttreatment score changes on the PHQ-9 and GAD-7. TAKEAWAY: After undergoing talk therapy, 71% of patients with a history of stroke and baseline depression or anxiety symptoms had reliable improvement in psychiatric symptoms, and 49% had reliable recovery, while only 7% had reliable deterioration. After treatment, mean PHQ-9 and GAD-7 scores decreased by 6.5 and 5.5 points, respectively, indicating moderate reductions in depression symptoms and large reductions in anxiety symptoms. Analysis adjusted for demographics and other covariates showed that patients who initiated psychological services 12 months or more after stroke had 20% lower odds of reliable recovery compared to those who initiated treatment within 6 months of stroke. Compared with a matched sample of individuals who never had a stroke, those with a history of stroke were less likely to reliably recover (odds ratio [OR], 0.9; P < .001) and more likely to reliably deteriorate (OR, 1.2; P = .04), but these differences disappeared after adjusting for physical comorbidities. IN PRACTICE: The study 'strongly supports the effectiveness of primary care psychological therapy as a first-line treatment for common mental health disorders after a stroke,' the researchers wrote. 'It is essential for general practitioners and other clinicians working with stroke survivors to screen for depression and anxiety symptoms and refer patients for psychological therapy as early as possible,' the lead investigator said in a press release. SOURCE: The study, led by Jae Won Suh, University College London, London, England, was published online on June 5 in Nature Mental Health . LIMITATIONS: The sample may not have represented all survivors of stroke, especially those with severe impairments or those from underrepresented ethnic backgrounds. The study also lacked detailed data on stroke severity, cognitive or sensory deficits, and prestroke mental health status, as well as information on whether depression or anxiety began before or after the stroke. Information on lifestyle factors and the burden of comorbidities was also limited. DISCLOSURES: This study was funded by the Alzheimer's Society. Some investigators reported having unrelated consulting roles and funding from various organizations. Full details are provided in the original article.
