Simpson, S. and Corney, R. and Fitzgerald, P. and Beecham, J.K. (2003) A randomized controlled trial to evaluate the effectiveness and cost-effectiveness of psychodynamic counselling for general practice patients with chronic depression. Psychological Medicine, 33 (2). pp. 229-239. ISSN 0033-2917.
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Background: Counsellors have been employed in general practice with little evidence of effectiveness. This study examined the effectiveness and cost-effectiveness of short-term counselling in general practice for patients with chronic depression either alone or combined with anxiety. Method: A randomized controlled trial with an economic evaluation was carried out in Derbyshire. One hundred and forty-five patients were recruited at seven GP practices by screening using the Beck Depression Inventory. Both the experimental and control group received routine GP treatment but the experimental group were also referred to the practice counsellor. Depression, anxiety and other mental health symptoms, social and interpersonal functioning and social support were measured at baseline, 6 months and 12 months. Comprehensive costs were also estimated. Results: There was an overall significant improvement in the actual scores over time, but there were no significant differences between the two groups on any of the measures at either 6 or 12 months. However fewer experimental group patients were still ‘cases’ on the BDI than controls at 12 months. There were no significant differences in the mean total costs, aggregate costs of services, or any service-group costs except for primary care, between the experimental and control groups over time. Conclusions: This trial demonstrates only very limited evidence of improved outcomes in those referred to counselling and increased primary care treatment costs in the short-term. Stricter referral criteria to exclude the more severely depressed in the group (BDI[gt-or-equal, slanted]24) might have yielded more conclusive results.
|Divisions:||Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Personal Social Services Research Unit|
|Depositing User:||Rosalyn Bass|
|Date Deposited:||21 May 2011 01:24|
|Last Modified:||07 Aug 2012 10:58|
|Resource URI:||http://kar.kent.ac.uk/id/eprint/26989 (The current URI for this page, for reference purposes)|
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