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What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression

  • JUDITH GELLATLY (a1), PETER BOWER (a2), SUE HENNESSY (a3), DAVID RICHARDS (a3), SIMON GILBODY (a3) and KARINA LOVELL (a1)
  • DOI: http://dx.doi.org/10.1017/S0033291707000062
  • Published online: 19 February 2007
Abstract
ABSTRACTBackground

Although self-help interventions are effective in treating depression, less is known about the factors that determine effectiveness (i.e. moderators of effect). This study sought to determine whether the content of self-help interventions, the study populations or aspects of study design were the most important moderators.

Method

Randomized trials of the effectiveness of self-help interventions versus controls in the treatment of depressive symptoms were identified using previous reviews and electronic database searches. Data on moderators (i.e. patient populations, study design, intervention content) and outcomes were extracted and analysed using meta-regression.

Results

Thirty-four studies were identified with 39 comparisons. Study design factors associated with greater effectiveness were unclear allocation concealment, observer-rated outcome measures and waiting-list control groups. Greater effectiveness was also associated with recruitment in non-clinical settings, patients with existing depression (rather than those ‘at risk’), contact with a therapist (i.e. guided self-help) and the use of cognitive behavioural therapy (CBT) techniques. However, only guided self-help remained significant in the multivariate analysis [regression coefficient 0·36, 95% confidence interval (CI) 0·05–0·68, p=0·03]. In the subset of guided studies, there were no significant associations between outcomes and the session length, content, delivery mode or therapist background.

Conclusions

The results provide some insights into moderators of self-help interventions, which might assist in the design of future interventions. However, the present study did not provide a comprehensive description, and other research methods might be required to identify factors associated with the effectiveness of self-help.

Copyright
Corresponding author
*Address for correspondence: Dr Peter Bower, National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL, UK. (Email: peter.bower@manchester.ac.uk)
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

J. Ackerson , F. Scogin , N. McKendree-Smith & R. Lyman (1998). Cognitive bibliotherapy for mild and moderate adolescent depressive symptomatology. Journal of Consulting and Clinical Psychology 66, 685690.

R. Baron & D. Kenny (1986). The moderator–mediator distinction in social psychological research: conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology 51, 11731182.

R. Churchill , V. Hunot , R. Corney , M. Knapp , H. McGuire , A. Tylee & S. Wessely (2002). A systematic review of controlled trials of the effectiveness and cost-effectiveness of brief psychological treatments for depression. Health Technology Assessment Vol. 5, No. 35.

J. Cohen (1988). Statistical Power Analysis for the Behavioural Sciences (2nd edn). Lawrence Erlbaum: New Jersey.

P. Cuijpers (1997). Bibliotherapy in unipolar depression: a meta-analysis. Journal of Behaviour Therapy and Experimental Psychiatry 28, 139147.

K. Dickersin , E. Manheimer , S. Wieland , K. Robinson , C. Lefebvre , S. McDonald & CENTRAL Development Group (2002). Development of the Cochrane Collaboration's CENTRAL Register of Controlled Clinical Trials. Evaluation and the Health Professions 25, 3864.

M. Egger , Smith G. Davey , M. Schneider & C. Minder (1997). Bias in meta-analysis detected by a simple, graphical test. British Medical Journal 315, 629634.

R. Elliott , C. Fischer & D. Rennie (1999). Evolving guidelines for publication of qualitative research studies in psychology and related fields. British Journal of Clinical Psychology 38, 213229.

P. Gotzsche (2000). Why we need a broad perspective on meta-analysis. British Medical Journal 321, 585586.

R. Gould & G. Clum (1993). A meta-analysis of self-help treatment approaches. Clinical Psychology Review 13, 169186.

J. Higgins & S. Thompson (2004). Controlling the risk of spurious findings from meta-regression. Statistics in Medicine 23, 16631682.

J. Higgins , S. Thompson , J. Deeks & D. Altman (2003). Measuring inconsistency in meta-analyses. British Medical Journal 327, 557560.

S. Hollis & F. Campbell (1999). What is meant by intention to treat analysis? Survey of published randomised controlled trials. British Medical Journal 319, 670674.

N. Jacobson , K. Dobson , P. Truax , M. Addis , K. Koerner , J. Gollan , E. Gortner & S. Prince (1996). A component analysis of cognitive-behavioural treatment for depression. Journal of Consulting and Clinical Psychology 64, 295304.

P. Lambert , A. Sutton , K. Abrams & D. Jones (2002). A comparison of summary patient-level covariates in meta-regression with individual patient data meta-analysis. Journal of Clinical Epidemiology 55, 8694.

P. Little , M. Dorward , G. Warner , M. Moore , K. Stephens , J. Senior & T. Kendrick (2004). Randomised controlled trial of effect of leaflets to empower patients in consultations in primary care. British Medical Journal 328, 441444.

R. Marrs (1995). A meta-analysis of bibliotherapy studies. American Journal of Community Psychology 23, 843870.

N. McKendree-Smith , M. Floyd & F. Scogin (2003). Self-administered treatments for depression: a review. Journal of Clinical Psychology 59, 275288.


M. Newman , T. Erickson , A. Przeworski & E. Dzus (2003). Self-help and minimal-contact therapies for anxiety disorders: is human contact necessary for therapeutic efficacy? Journal of Clinical Psychology 59, 251274.

J. Proudfoot , C. Ryden , B. Everitt , D. Shapiro , D. Goldberg , A. Mann , A. Tylee , I. Marks & J. Gray (2004). Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial. British Journal of Psychiatry 185, 4654.

R. Rahe , C. Taylor , R. Tolles , M. Newhall , T. Veach & S. Bryson (2002). A novel stress and coping workplace program reduces illness and healthcare utilization. Psychosomatic Medicine 64, 278286.

R. Rosenthal (1979). The ‘File Drawer Problem’ and tolerance for null results. Psychological Bulletin 86, 638641.

P. Royle & N. Waugh (2005). A simplified search strategy for identifying randomised controlled trials for systematic reviews of health care interventions: a comparison with more exhaustive strategies. BMC Medical Research Methodology 5, 23.

K. Schulz , I. Chalmers , R. Hayes & D. Altman (1995). Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials. Journal of the American Medical Association 273, 408412.

K. Schulz & D. Grimes (2002). Allocation concealment in randomised trials: defending against deciphering. Lancet 359, 614618.

F. Scogin , J. Bynum , G. Stephens & S. Calhoon (1990). Efficacy of self-administered treatment programs: meta-analytic review. Professional Psychology: Research and Practice 21, 4247.

F. Scogin , A. Hanson & D. Welsh (2003). Self-administered treatment in stepped-care models of depression treatment. Journal of Clinical Psychology 59, 341349.

W. Shadish & S. Baldwin (2005). Effects of behavioral marital therapy: a meta-analysis of randomized controlled trials. Journal of Consulting and Clinical Psychology 73, 614.

S. Thompson & J. Higgins (2002). How should meta-regression analyses be undertaken and interpreted? Statistics in Medicine 21, 15591573.

G. Andersson , J. Bergstrom , F. Hollandare , L. Ekselius & P. Carlbring (2004). Delivering cognitive behavioural therapy for mild to moderate depression via the internet: predicting outcome at 6 month follow up. Verhaltenstherapie 14, 185189.

W. Bowers , S. Stuart , R. McaFarlane & L. Gorman (1993). Use of computer-administered cognitive-behaviour therapy with depressed inpatients. Depression 1, 294299.

D. Bowman , F. Scogin & B. Lyrene (1995). The efficacy of self-examination therapy and cognitive bibliotherapy in the treatment of mild to moderate depression. Psychotherapy Research 5, 131140.

H. Christensen , K. Griffiths & A. Jorm (2004). Delivering interventions for depression by using the internet: randomised controlled trial. British Medical Journal 328, 265.

G. Clarke , E. Reid , D. Eubanks , E. O'Connor , L. DeBar , C. Kelleher , F. Lynch & S. Nunley (2002). Overcoming depression on the internet (ODIN): a randomized controlled trial of an internet depression skills intervention programme. Journal of Medical Internet Research 4, e14.

J. Fletcher , K. Lovell , P. Bower , M. Campbell & C. Dickens (2005). Process and outcome of a non-facilitated self-help manual for anxiety and depression in primary care: a pilot study. Behavioral and Cognitive Psychotherapy 33, 319331.

M. Floyd , F. Scogin , N. McKendree-Smith , D. Floyd & P. Rokke (2004). Cognitive therapy for depression: a comparison of individual psychotherapy and bibliotherapy for depressed older adults. Behavior Modification 28, 297318.

K. Griffiths & H. Christensen (2000). Quality of web based information on treatment of depression: cross sectional survey. British Medical Journal 321, 15111515.

P. Grime (2004). Computerized cognitive behavioural therapy at work: a randomized controlled trial in employees with recent stress-related absenteeism. Occupational Medicine 54, 353359.

N. Holdsworth , R. Paxton , S. Seidel , D. Thomson & S. Shrubb (1996). Parallel evaluations of new guidance materials for anxiety and depression in primary care. Journal of Mental Health 5, 195207.

K. Jacob , D. Bhugra & A. Mann (2002). A randomised controlled trial of an educational intervention for depression among Asian women in primary care in the United Kingdom. International Journal of Social Psychiatry 48, 139148.

C. Jamison & F. Scogin (1995). The outcome of cognitive bibliotherapy with depressed adults. Journal of Consulting and Clinical Psychology 63, 644650.

A. Jorm , K. Griffiths , H. Christensen , A. Korten , R. Parslow & B. Rodgers (2003). Providing information about the effectiveness of treatment options to depressed people in the community: a randomized controlled trial of effects on mental health literacy, help-seeking and symptoms. Psychological Medicine 33, 10711079.

P. Landreville & L. Bissonnette (1997). Effects of cognitive bibliotherapy for depressed older adults with a disability. Clinical Gerontologist 17, 3555.

P. Little , M. Dorward , G. Warner , M. Moore , K. Stephens , J. Senior & T. Kendrick (2004). Randomised controlled trial of effect of leaflets to empower patients in consultations in primary care. British Medical Journal 328, 444.

S. Patten (2003). Prevention of depressive symptoms through the use of distance technologies. Psychiatric Services 54, 396398.

J. Proudfoot , D. Goldberg , A. Mann , B. Everitt , I. Marks & J. Gray (2003). Computerized, interactive, multimedia cognitive-behavioural program for anxiety and depression in general practice. Psychological Medicine 33, 217227.

M. Reid , C. Glazener , G. Murray & G. Taylor (2002). A two-centred pragmatic randomised controlled trial of two interventions of postnatal support. British Journal of Obstetrics and Gynaecology 109, 11641170.

P. Salkovskis , K. Rimes , D. Stephenson , G. Sacks & J. Scott (2005). A randomized controlled trial of the use of self-help materials in addition to standard general practice treatment of depression compared to standard treatment alone. Psychological Medicine 36, 325333.

M. Schmidt & W. Miller (1983). Amount of therapist contact and outcome in a multidimensional depression treatment program. Acta Psychiatrica Scandinavica 67, 319332.

F. Scogin , D. Hamblin & L. Beutler (1987). Bibliotherapy for depressed older adults: a self-help alternative. The Gerontologist 27, 383387.

F. Scogin , C. Jamison & N. Davis (1990). Two year follow-up of bibliotherapy for depression in older adults. Journal of Consulting and Clinical Psychology 58, 665667.

F. Scogin , C. Jamison & K. Gochneaur (1989). Comparative efficacy of cognitive and behavioral bibliotherapy for mildly and moderately depressed older adults. Journal of Consulting and Clinical Psychology 57, 403407.

J. Webster , J. Linnane , J. Roberts , S. Starrenburg , J. Hinson & L. Dibley (2003). IDentifty, Educate and Alert (IDEA) trial: an intervention to reduce postnatal depression. British Journal of Obstetrics and Gynaecology 110, 842846.

G. Willemse , F. Smit , P. Cuijpers & B. Tiemens (2004). Minimal contact psychotherapy for sub-threshold depression in primary care: randomised trial. British Journal of Psychiatry 185, 416421.

J. Wollersheim & G. Wilson (1991). Group treatment of unipolar depression: a comparison of coping, supportive, bibliotherapy and delayed treatment groups. Professional Psychology: Research and Practice 22, 496502.

K. Zetterqvist , J. Maanmies , L. Strom & G. Andersson (2003). Randomized controlled trial of internet-based stress management. Cognitive Behaviour Therapy 32, 151160.

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