The impact of initial depression and anxiety levels on symptom severity change during psychological treatment for common mental disorders: a systematic review.
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| Title: | The impact of initial depression and anxiety levels on symptom severity change during psychological treatment for common mental disorders: a systematic review. |
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| Authors: | Kamardina, Anna (AUTHOR), Saunders, Rob (AUTHOR), Broglia, Emma (AUTHOR) |
| Source: | Journal of Mental Health. Jun2026, Vol. 35 Issue 3, p354-374. 21p. |
| Subjects: | Anxiety treatment, Mental illness treatment, Psychotherapy, Pearson correlation (Statistics), Suicidal ideation, Unemployment, Severity of illness index, Meta-analysis, Descriptive statistics, Systematic reviews, MEDLINE, Medical databases, Online information services, Data analysis software, Confidence intervals, Interpersonal relations, Mental depression, Psychology information storage & retrieval systems, Regression analysis, Adults |
| Geographic Terms: | United Kingdom |
| Abstract: | Background: Depression and anxiety are highly comorbid conditions, which may impact treatment response. Aims: We intended to examine how depression and anxiety symptoms change during psychological interventions for adults and how the initial severity is associated with distinct trajectory classes. Methods: We identified papers examining longitudinal changes in depression and anxiety. Trajectory classes were grouped into responders, improvers and non-improvers. Narrative synthesis, alongside meta-analysis, was applied to explore the number and nature of classes, their associations with study characteristics and predictors of trajectory class membership. This study was pre-registered on International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023393155), and the authors followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Results: We identified 18 papers, including 22 models with two to six classes. Responding and non-improving classes prevailed. Meta-regression revealed no characteristics associated with the proportion of these classes. Initial depression and anxiety levels predicted trajectory class membership for each other, but not always non-response. Unemployment, suicidality, social functioning impairment, treatment type and medication use predicted following non-responding trajectory. Conclusion: Our findings highlight the complex relationship between initial anxiety and depression severity and their changes during psychological interventions. They provide practitioners with insights into factors associated with non-response patterns of symptom change. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Background: Depression and anxiety are highly comorbid conditions, which may impact treatment response. Aims: We intended to examine how depression and anxiety symptoms change during psychological interventions for adults and how the initial severity is associated with distinct trajectory classes. Methods: We identified papers examining longitudinal changes in depression and anxiety. Trajectory classes were grouped into responders, improvers and non-improvers. Narrative synthesis, alongside meta-analysis, was applied to explore the number and nature of classes, their associations with study characteristics and predictors of trajectory class membership. This study was pre-registered on International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023393155), and the authors followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Results: We identified 18 papers, including 22 models with two to six classes. Responding and non-improving classes prevailed. Meta-regression revealed no characteristics associated with the proportion of these classes. Initial depression and anxiety levels predicted trajectory class membership for each other, but not always non-response. Unemployment, suicidality, social functioning impairment, treatment type and medication use predicted following non-responding trajectory. Conclusion: Our findings highlight the complex relationship between initial anxiety and depression severity and their changes during psychological interventions. They provide practitioners with insights into factors associated with non-response patterns of symptom change. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 09638237 |
| DOI: | 10.1080/09638237.2026.2622085 |
