Table 23GRADE Summary of Findings for Disclosure-Related Distress

Outcome, follow-up, no. participants (trials) Findings Certainty of the evidence (GRADE) What happens?
Disclosure-related distress

Post-intervention: 84 (1 RCT 50 )

Longest follow-up: 62 (1 RCT 50 )

One RCT50 with high risk of bias (unclear direction) reported on participants’ distress related to disclosure of mental illness. The outcome was assessed by a question about how distressed or worried they are about disclosing mental illness. Answers were rated from 1 (not at all) to 7 (very much). This single item was used as a screening item for study inclusion, with a score of 4 or more required to be enrolled to the trial. This RCT compared the effectiveness of HOP program to treatment as usual among adolescent psychiatric patients, who were mostly were female (69.3%), born in Germany (94.8%) and were around 22 months since the first psychiatric diagnosis.

At post-intervention, the between-group difference for change from baseline was statistically significant, with the mean between-group difference of –0.44 (95% CI (–0.79 to –0.08).

At the 6-week follow-up, the distress related to disclosure of mental illness was significantly lower in HOP group compared to TAU group (mean between-group difference for change from baseline = –0.78 [95% CI –1.16 to –0.40]).

 Very low

due to serious concerns for risk of bias, concerns for inconsistency, serious concerns for indirectness and imprecision.a

HOP may be favoured vs. TAU with respects to attitudes to disclosure post-intervention, but the evidence is very uncertain.

HOP may be favoured vs. TAU with respects to attitudes to disclosure at longest follow-up but the evidence is very uncertain.

HOP= Honest, Open, Proud; HOP-C = Honest, Open, Proud–College; RCT = randomized controlled trial; TAU = treatment as usual

a

At post-intervention and at follow-up: rated down once for risk of bias due to serious concerns about the potential for bias arising from missing outcome data and bias in measurement of the outcomes (participant reported subjective outcomes); rated down once due to serious concerns for inconsistency because of limited of evidence of consistency as only 1 trial was available that reported on the outcome at all time points; rated down once due to serious concerns for indirectness because only 1 program (HOP/HOP-C) was identified and the population seemed relatively homogenous, thereby lowering the generalizability of findings to peer support programs in general.; rated down once due to serious concerns about imprecision because of the relatively lower sample size in each comparison; publication bias was not detected.

From: Peer Support Programs for Youth Mental Health

Cover of Peer Support Programs for Youth Mental Health
Peer Support Programs for Youth Mental Health: Health Technology Assessment [Internet].
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