A systematic review of controlled trials of the effectiveness and cost-effectiveness of brief psychological treatments for depression

Churchill R, Hunot V, Corney R, Knapp M. McGuire H, Tylee A, Wessley S
Record ID 32002000905
Authors' objectives:

The aims of this report were: - To conduct a systematic review and, where possible, a meta-analysis of all controlled clinical trials (CCTs) in which brief psychological treatments were compared with one another or treatment as usual in the treatment of depression. - To describe the internal validity, statistical power and external validity of the identified trials. - To compare the overall efficacy of all variants of brief psychological treatments with treatment as usual. - To compare the efficacy of cognitive behavioural therapy (CBT) with treatment as usual, interpersonal therapy (IPT), psychodynamic therapy (PDT) and supportive therapy (ST). - To compare the efficacy of IPT, PDT and ST with treatment as usual and with one another. - To compare the efficacy of all variants of individual and group therapies. - To summarise all available cost data from controlled trials of brief psychological treatments for depression.

Authors' recommendations: Based on the best available evidence, it would appear that some forms of brief psychological treatments, particularly those derived from cognitive/behavioural models, are beneficial in the treatment of people with depression being managed outside hospital settings. Little can be said about the efficacy of different types of individual versus group therapy because all the trials comparing these formats used cognitive therapy or behavioural therapy. In these trials, greater efficacy for individual formats was suggested. Baseline severity, the methods used to identify patients and possibly the number of sessions offered are factors likely to affect outcome. Little can be said about the potential impact of socio-demographic characteristics of patients, the specific effects of client motivation and therapeutic alliance, any potential adverse events associated with psychological treatments, the short- and long-term outcomes of psychological treatments, the differential effects of alternative models, particularly PDT and client-centred therapies, or the immediate and long-term economic consequences attached to the provision of psychological treatments in primary care.
Authors' methods: Systematic review
Project Status: Completed
URL for project: http://www.hta.ac.uk/1003
Year Published: 2001
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Behavior Therapy
  • Costs and Cost Analysis
  • Counseling
  • Depression
  • Family Therapy
  • Marital Therapy
  • Psychotherapy, Brief
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: 2009 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.