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Meta-Analysis
. 2024 Apr;65(2):311-320.
doi: 10.1111/sjop.12976. Epub 2023 Oct 30.

Clinically representative therapy for Nordic adult outpatients with common mental health problems: A systematic review and meta-analysis

Martin Brattmyr  1 , Martin Schevik Lindberg  1   2 , Jakob Lundqvist  1 , Lars-Göran Öst  3 , Stian Solem  1 , Odin Hjemdal  1 , Audun Havnen  1   4
Affiliations
Meta-Analysis

Clinically representative therapy for Nordic adult outpatients with common mental health problems: A systematic review and meta-analysis

Martin Brattmyr et al. Scand J Psychol. 2024 Apr.

Abstract

There is a knowledge gap regarding clinically representative therapy given in routine settings, that is treatment as usual (TAU), for patients with common mental health problems (CMHP). This review and meta-analysis aimed to investigate what characterizes clinically representative therapy in Nordic routine clinics and meta-analyze the outcome of such treatment. Databases (PubMed, EMBASE, PsychINFO, and SveMed+) were searched for TAU, CMHP, and Nordic countries, together with backward and forward search in Scopus (7 November 2022). Studies were either randomized controlled trials (RCT) or open trials, using prospective study designs, examining heterogeneous outpatient groups in routine treatment. Within- and between-group effect sizes (ES), using random effects model, and moderator analyses were calculated. Eleven studies (n = 1,413), demonstrated a small to moderate within-group ES with high heterogeneity (g = 0.49, I2 = 90%). ESs in RCTs were significantly smaller than in open trials. TAU had a marginally smaller ES (g = -0.21; adjusted for publication bias g = -0.06) compared to a broad set of clinical interventions. Clinically representative therapy in the Nordic countries demonstrated a wide variety of characteristics and also a marginally lower ES compared to other interventions. The ESs were smaller than other meta-analyses examining evidence-based treatments in routine treatment.

Keywords: Clinically representative treatment; care as usual; common mental health problems; meta-analysis; treatment as usual (TAU).

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