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  • Psychological therapy reduced depression earlier (4 months) but at 1 year was not better than usual general practitioner care

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Therapeutics
Psychological therapy reduced depression earlier (4 months) but at 1 year was not better than usual general practitioner care

https://doi.org/10.1136/ebm.6.4.119

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    (2000) BMJ 321, 1383. Ward E, King M, Lloyd M, et al.. Randomised controlled trial of non-directive counselling, cognitive-behaviour therapy, and usual general practitioner care for patients with depression. I: Clinical effectiveness.. Dec 2;. :. –8.
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 QUESTION: In patients with depression, is psychological therapy (non-directive counselling or cognitive behavioural therapy [CBT]) more effective than usual general practitioner (GP) care?

    Design

    Randomised (allocation concealed*), unblinded,* controlled trial with 1 year follow up. This abstract reports the results of the randomised 3 way comparison only (197 of 464 patients).

    Setting

    13 general practices in northern London and 11 practices in greater Manchester, UK.

    Patients

    197 patients who were ≥18 years of age (mean age 37 y, 77% women) and were depressed or depressed and anxious (score ≥14 on Beck Depression Inventory [BDI]). Exclusion criteria were serious suicidal intent, psychological treatment in previous 6 months, use of antidepressants, restricted mobility, organic brain syndromes, or inability to complete questionnaires. Follow up was 91% at 4 months and 84% at 1 year.

    Intervention

    Patients were allocated to non-directive counselling (n=67), CBT (n=63), …

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    Footnotes

    • Source of funding: NHS Executive, Health Technology Assessment Programme.

    • For correspondence: Professor M B King, Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, University College London, London NW3 2PF, UK. Fax +44 (0)20 7830 2808.

    • ↵* See glossary.

    • ↵† Rogers CR. On becoming a person: a therapist's view of psychotherapy. Boston: Houghton Mifflin; 1961.

    • ↵‡ Mean differences and CIs calculated from data in article.