Psychological interventions for major depression in primary care: a meta-analytic review of randomized controlled trials

Abstract Objective Various studies have tested psychological therapies in the treatment of depression in primary care. Yet, concerns over their clinical effectiveness, as compared to usual general practitioner (GP) care or treatment with antidepressants, have been raised. The present meta-analysis w...

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Bibliographic Details
Published in:General hospital psychiatry 2008-07, Vol.30 (4), p.293-302
Main Authors: Bortolotti, Biancamaria, M.D, Menchetti, Marco, M.D, Bellini, Francesca, M.D, Montaguti, Milena Barbara, M.D, Berardi, Domenico, M.D
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Amitriptyline - therapeutic use
Antidepressive Agents - therapeutic use
Antidepressive Agents, Tricyclic - therapeutic use
Biological and medical sciences
Cognitive Therapy - methods
Counseling
Depressive disorder
Depressive Disorder, Major - drug therapy
Depressive Disorder, Major - psychology
Depressive Disorder, Major - therapy
Family practice
Family Practice - statistics & numerical data
Female
Fluvoxamine - therapeutic use
Humans
Individual psychotherapy
Male
Medical sciences
Middle Aged
Primary health care
Primary Health Care - statistics & numerical data
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Psychotherapies. Psychological and clinical counseling
Psychotherapy
Psychotherapy - methods
Psychotherapy, Brief - methods
Randomized Controlled Trials as Topic - statistics & numerical data
Serotonin Uptake Inhibitors - therapeutic use
Therapy, Computer-Assisted - methods
Treatment Outcome
Treatments
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Summary:Abstract Objective Various studies have tested psychological therapies in the treatment of depression in primary care. Yet, concerns over their clinical effectiveness, as compared to usual general practitioner (GP) care or treatment with antidepressants, have been raised. The present meta-analysis was aimed at assessing currently available evidence on the topic. Method A systematic search of electronic databases identified 10 randomized controlled trials comparing psychological forms of intervention with either usual GP care or antidepressant medication for major depression. Meta-analytical procedures were used to examine the impact of psychological intervention in primary care on depression, as compared to usual GP care and antidepressant treatment. Results The main analyses showed greater effectiveness of psychological intervention over usual GP care in both the short term [standardized mean difference (SMD)=−0.42, 95% confidence interval (CI)=−0.59 to −0.26, n =408] and long term (SMD=−0.30, 95% CI=−0.45 to −0.14, n =433). The heterogeneity test was not significant in the short term at the P
ISSN:0163-8343
1873-7714
DOI:10.1016/j.genhosppsych.2008.04.001