Impact of long-term medical conditions on the outcomes of psychological therapy for depression and anxiety.

<bold>Background: </bold>Long-term conditions often coexist with depression and anxiety.<bold>Aims: </bold>To assess the effectiveness of stepped-care psychological therapies for patients with long-term conditions.<bold>Method: </bold>Data from 28 498 patients were analysed using regression to model depression (Patient Health Questionnaire (PHQ-9)) and anxiety (Generalised Anxiety Disorder scale (GAD-7)) outcomes. Post-treatment symptoms and effect sizes (d) were estimated for individuals with and without long-term conditions, controlling for covariates. The likelihood of access and response to intensive psychological interventions was also examined.<bold>Results: </bold>Higher post-treatment symptoms were predicted for patients with musculoskeletal problems (d = 0.22-0.27), chronic obstructive pulmonary disease (d = 0.26-0.33), diabetes (d = 0.05-0.13) and psychotic disorders (d = 0.50-0.58). Most long-term conditions were associated with greater odds of accessing high-intensity therapies, yet individuals who accessed these continued to have higher average post-treatment symptoms.<bold>Conclusions: </bold>Some long-term conditions are associated with greater intensity of care and poorer outcomes after therapy. [ABSTRACT FROM AUTHOR]