Effectiveness of a mental health stepped-care programme for healthcare workers with psychological distress in crisis settings: a multicentre randomised controlled trial.
Por:
Mediavilla R, Félez M, McGreevy KR, Monistrol A, Bravo-Ortiz MF, Bayón C, Giné I, Villaescusa R, Muñoz-Sanjosé A, Aguilar-Ortiz S, Figueiredo N, Nicaise P, Park AL, Petri-Romão P, Purgato M, Witteveen AB, Underhill J, Barbui C, Bryant R, Kalisch R, Lorant V, David McDaid, Melchior M, Sijbrandij M, Haro JM and Ayuso-Mateos JL
Publicada:
1 jun 2023
Categoría:
Psychiatry and mental health
Resumen:
BACKGROUND: Evidence-based mental health interventions to support healthcare workers (HCWs) in crisis settings are scarce. OBJECTIVE: To evaluate the capacity of a mental health intervention in reducing anxiety and depression symptoms in HCWs, relative to enhanced care as usual (eCAU), amidst the COVID-19 pandemic. METHODS: We conducted an analyst-blind, parallel, multicentre, randomised controlled trial. We recruited HCWs with psychological distress from Madrid and Catalonia (Spain). The intervention arm received a stepped-care programme consisting of two WHO-developed interventions adapted for HCWs: Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). Each intervention lasted 5 weeks and was delivered remotely by non-specialist mental health providers. HCWs reporting psychological distress after DWM completion were invited to continue to PM+. The primary endpoint was self-reported anxiety/depression symptoms (Patient Health Questionnaire-Anxiety and Depression Scale) at week 21. FINDINGS: Between 3 November 2021 and 31 March 2022, 115 participants were randomised to stepped care and 117 to eCAU (86% women, mean age 37.5). The intervention showed a greater decrease in anxiety/depression symptoms compared with eCAU at the primary endpoint (baseline-adjusted difference 4.4, 95% CI 2.1 to 6.7; standardised effect size 0.8, 95% CI 0.4 to 1.2). No serious adverse events occurred. CONCLUSIONS: Brief stepped-care psychological interventions reduce anxiety and depression during a period of stress among HCWs. CLINICAL IMPLICATIONS: Our results can inform policies and actions to protect the mental health of HCWs during major health crises and are potentially rapidly replicable in other settings where workers are affected by global emergencies. TRIAL REGISTRATION NUMBER: NCT04980326.
Filiaciones:
Mediavilla R:
Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
Instituto de Investigación Sanitaria del Hospital Universitario La Princesa (IIS-Princesa), Madrid, Spain
Leibniz Institute for Resilience Research, Mainz, Germany
Félez M:
Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
McGreevy KR:
Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
Monistrol A:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
Bravo-Ortiz MF:
Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
Department of Psychiatry, Hospital Universitario La Paz - IdiPAZ, Madrid, Spain
Bayón C:
Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
Department of Psychiatry, Hospital Universitario La Paz - IdiPAZ, Madrid, Spain
Giné I:
Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
Villaescusa R:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
Muñoz-Sanjosé A:
Department of Psychiatry, Hospital Universitario La Paz - IdiPAZ, Madrid, Spain
Aguilar-Ortiz S:
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
Figueiredo N:
Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Institut national de la santé et de la recherche médicale (INSERM), Paris, France
Nicaise P:
Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
Park AL:
Department of Health Policy, London School of Economics and Political Science, London, UK
Petri-Romão P:
Leibniz Institute for Resilience Research, Mainz, Germany
Purgato M:
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation - Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
Witteveen AB:
Department of Clinical Neuro- and Developmental Psychology - WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije University, Amsterdam, Netherlands
Underhill J:
Department of Clinical Neuro- and Developmental Psychology - WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije University, Amsterdam, Netherlands
Barbui C:
WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation - Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Verona, Italy
Bryant R:
School of Psychology, UNSW, Sydney, New South Wales, Australia
Kalisch R:
Leibniz Institute for Resilience Research, Mainz, Germany
Neuroimaging Center (NIC) - Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
Lorant V:
Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
David McDaid:
Department of Health Policy, London School of Economics and Political Science, London, UK
Melchior M:
Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Institut national de la santé et de la recherche médicale (INSERM), Paris, France
Sijbrandij M:
Department of Clinical Neuro- and Developmental Psychology - WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije University, Amsterdam, Netherlands
Haro JM:
Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
Ayuso-Mateos JL:
Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
Instituto de Investigación Sanitaria del Hospital Universitario La Princesa (IIS-Princesa), Madrid, Spain
Open Access
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