Strength and limitations
depression, anxiety
The strength of the present analysis is its thorough assessment of anxiety and depression outcomes during a natural crisis situation. A limitation of the study is the low response rate. Although we tried several ways to contact participants, we could only include participants who were accessible and willing to participate. Small numbers of subjects may result in lower statistical power. Thus, we want to emphasize that the interpretations of our results is tentative.Moreover, it is possible that only particularly motivated and psychologically less stressed–or conversely, particularly stressed–patients participated. We tried to counteract potential selection bias by repeatedly contacting reluctant participants. Compared to the original trial, participants at follow-up were older than the elapsed time would suggest. This may be why the online questionnaire was so poorly received. We tried to address this through phone calls and postal letters. In our study, anxiety severity (OASIS) showed a difference between IG and CG. However, due to the cross-sectional character of the OASIS-data, we cannot draw firm conclusions regarding the long-term effectiveness of a practice team-based CBT-intervention in primary care. The PARADIES intervention is not part of standard care in Germany and thus, only available from few GPs.