Cognitive behavioural therapy for mood and anxiety disorders delivered by mental health nurses: Outcomes and predictors of response in a real-world outpatient care setting

Abstract

Objective: The need for mental health nurses (MHNs) to incorporate psychological techniques into their nursing practice has been recognised worldwide. Further evidence from real-world settings is necessary to demonstrate that MNH-led cognitive behavioural therapy (CBT) is an effective approach that can be used in clinical practice. This study aimed to explore the clinical effectiveness and predictors of MNH-led CBT for mood and anxiety disorders in routine outpatient care settings in Japan. Methods: This retrospective study collected data through a medical record review of 69 participants who underwent MHN-led CBT between January 2015 and December 2019. Results: Participants who received MHN-led CBT demonstrated significant improvements in depressive/anxiety symptoms, health-related quality of life and primary psychiatrists' impressions of condition severity (all p <.001). At the end of therapy, more than half of the participants (56.5%) showed positive clinical significance (recovered/improved) based on cutoff points and reliable change indices of validated depression and anxiety measurement scores. Furthermore, an increase in the baseline anxiety score predicted lower odds of achieving positive clinical significance (odds ratio = 0.87, 95% confidence interval = 0.79-0.96). Conclusions: Despite several limitations, mainly owing to its single-group retrospective design, this real-world evidence of MHN-led CBT bridges the gap between research and clinical practice, contributing to the widespread use of MHN-led CBT in mental health services worldwide.