The effects of self-management interventions on depressive symptoms in adults with chronic physical disease(s) experiencing depressive symptomatology: a systematic review and meta-analysis

Abstract Background Chronic diseases are the leading cause of death worldwide. It is estimated that 20% of adults with chronic physical diseases experience concomitant depression, increasing their risk of morbidity and mortality. Low intensity psychosocial interventions, such as self-management, are...

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Main Authors: Lydia Ould Brahim, Sylvie D. Lambert, Nancy Feeley, Chelsea Coumoundouros, Jamie Schaffler, Jane McCusker, Erica E. M. Moodie, John Kayser, Kendall Kolne, Eric Belzile, Christine Genest
Format: Article
Language:English
Published: BMC 2021-11-01
Series:BMC Psychiatry
Subjects:
Online Access:https://doi.org/10.1186/s12888-021-03504-8
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author Lydia Ould Brahim
Sylvie D. Lambert
Nancy Feeley
Chelsea Coumoundouros
Jamie Schaffler
Jane McCusker
Erica E. M. Moodie
John Kayser
Kendall Kolne
Eric Belzile
Christine Genest
author_facet Lydia Ould Brahim
Sylvie D. Lambert
Nancy Feeley
Chelsea Coumoundouros
Jamie Schaffler
Jane McCusker
Erica E. M. Moodie
John Kayser
Kendall Kolne
Eric Belzile
Christine Genest
author_sort Lydia Ould Brahim
collection DOAJ
description Abstract Background Chronic diseases are the leading cause of death worldwide. It is estimated that 20% of adults with chronic physical diseases experience concomitant depression, increasing their risk of morbidity and mortality. Low intensity psychosocial interventions, such as self-management, are part of recommended treatment; however, no systematic review has evaluated the effects of depression self-management interventions for this population. The primary objective was to examine the effect of self-management interventions on reducing depressive symptomatology in adults with chronic disease(s) and co-occurring depressive symptoms. Secondary objectives were to evaluate the effect of these interventions on improving other psychosocial and physiological outcomes (e.g., anxiety, glycemic control) and to assess potential differential effect based on key participant and intervention characteristics (e.g., chronic disease, provider). Methods Studies comparing depression self-management interventions to a control group were identified through a) systematic searches of databases to June 2018 [MEDLINE (1946 -), EMBASE (1996 -), PsycINFO (1967 -), CINAHL (1984 -)] and b) secondary ‘snowball’ search strategies. The methodological quality of included studies was critically reviewed. Screening of all titles, abstracts, and full texts for eligibility was assessed independently by two authors. Data were extracted by one author and verified by a second. Results Fifteen studies were retained: 12 for meta-analysis and three for descriptive review. In total, these trials included 2064 participants and most commonly evaluated interventions for people with cancer (n = 7) or diabetes (n = 4). From baseline to < 6-months (T1), the pooled mean effect size was − 0.47 [95% CI −0.73, − 0.21] as compared to control groups for the primary outcome of depression and − 0.53 [95% CI −0.91, − 0.15] at ≥ 6-months (T2). Results were also significant for anxiety (T1) and glycemic control (T2). Self-management skills of decision-making and taking action were significant moderators of depression at T1. Conclusion Self-management interventions show promise in improving depression and anxiety in those with concomitant chronic physical disease. The findings may contribute to the development of future Self-management interventions and delivering evidence-based care to this population. Further high-quality RCTs are needed to identify sources of heterogeneity and investigate key intervention components.
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spelling doaj.art-105fc013470b42bf97e7b39e02a304902022-12-21T19:23:13ZengBMCBMC Psychiatry1471-244X2021-11-0121113510.1186/s12888-021-03504-8The effects of self-management interventions on depressive symptoms in adults with chronic physical disease(s) experiencing depressive symptomatology: a systematic review and meta-analysisLydia Ould Brahim0Sylvie D. Lambert1Nancy Feeley2Chelsea Coumoundouros3Jamie Schaffler4Jane McCusker5Erica E. M. Moodie6John Kayser7Kendall Kolne8Eric Belzile9Christine Genest10Ingram School of Nursing, McGill UniversityIngram School of Nursing, McGill UniversityIngram School of Nursing, McGill UniversityHealthcare Sciences and e-Health, Department of Women’s and Children’s Health, Uppsala UniversitySt. Mary’s Research CentreSt. Mary’s Research CentreDepartment of Epidemiology, Biostatistics, and Occupational Health, McGill University MontrealCIUSSS du Centre-Sud-de-l’Île-de-MontréaTrillium Lakelands District School BoardSt. Mary’s Research CentreFaculty of Nursing Sciences, Université de MontrealAbstract Background Chronic diseases are the leading cause of death worldwide. It is estimated that 20% of adults with chronic physical diseases experience concomitant depression, increasing their risk of morbidity and mortality. Low intensity psychosocial interventions, such as self-management, are part of recommended treatment; however, no systematic review has evaluated the effects of depression self-management interventions for this population. The primary objective was to examine the effect of self-management interventions on reducing depressive symptomatology in adults with chronic disease(s) and co-occurring depressive symptoms. Secondary objectives were to evaluate the effect of these interventions on improving other psychosocial and physiological outcomes (e.g., anxiety, glycemic control) and to assess potential differential effect based on key participant and intervention characteristics (e.g., chronic disease, provider). Methods Studies comparing depression self-management interventions to a control group were identified through a) systematic searches of databases to June 2018 [MEDLINE (1946 -), EMBASE (1996 -), PsycINFO (1967 -), CINAHL (1984 -)] and b) secondary ‘snowball’ search strategies. The methodological quality of included studies was critically reviewed. Screening of all titles, abstracts, and full texts for eligibility was assessed independently by two authors. Data were extracted by one author and verified by a second. Results Fifteen studies were retained: 12 for meta-analysis and three for descriptive review. In total, these trials included 2064 participants and most commonly evaluated interventions for people with cancer (n = 7) or diabetes (n = 4). From baseline to < 6-months (T1), the pooled mean effect size was − 0.47 [95% CI −0.73, − 0.21] as compared to control groups for the primary outcome of depression and − 0.53 [95% CI −0.91, − 0.15] at ≥ 6-months (T2). Results were also significant for anxiety (T1) and glycemic control (T2). Self-management skills of decision-making and taking action were significant moderators of depression at T1. Conclusion Self-management interventions show promise in improving depression and anxiety in those with concomitant chronic physical disease. The findings may contribute to the development of future Self-management interventions and delivering evidence-based care to this population. Further high-quality RCTs are needed to identify sources of heterogeneity and investigate key intervention components.https://doi.org/10.1186/s12888-021-03504-8Self-managementChronic diseaseDepressionAnxietyDecision-makingSystematic review
spellingShingle Lydia Ould Brahim
Sylvie D. Lambert
Nancy Feeley
Chelsea Coumoundouros
Jamie Schaffler
Jane McCusker
Erica E. M. Moodie
John Kayser
Kendall Kolne
Eric Belzile
Christine Genest
The effects of self-management interventions on depressive symptoms in adults with chronic physical disease(s) experiencing depressive symptomatology: a systematic review and meta-analysis
BMC Psychiatry
Self-management
Chronic disease
Depression
Anxiety
Decision-making
Systematic review
title The effects of self-management interventions on depressive symptoms in adults with chronic physical disease(s) experiencing depressive symptomatology: a systematic review and meta-analysis
title_full The effects of self-management interventions on depressive symptoms in adults with chronic physical disease(s) experiencing depressive symptomatology: a systematic review and meta-analysis
title_fullStr The effects of self-management interventions on depressive symptoms in adults with chronic physical disease(s) experiencing depressive symptomatology: a systematic review and meta-analysis
title_full_unstemmed The effects of self-management interventions on depressive symptoms in adults with chronic physical disease(s) experiencing depressive symptomatology: a systematic review and meta-analysis
title_short The effects of self-management interventions on depressive symptoms in adults with chronic physical disease(s) experiencing depressive symptomatology: a systematic review and meta-analysis
title_sort effects of self management interventions on depressive symptoms in adults with chronic physical disease s experiencing depressive symptomatology a systematic review and meta analysis
topic Self-management
Chronic disease
Depression
Anxiety
Decision-making
Systematic review
url https://doi.org/10.1186/s12888-021-03504-8
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