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

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

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dc.contributor.author Gellatly, Judith en_GB
dc.contributor.author Bower, Peter en_GB
dc.contributor.author Hennessy, Sue en_GB
dc.contributor.author Richards, David en_GB
dc.contributor.author Gilbody, Simon en_GB
dc.contributor.author Lovell, Karina en_GB
dc.contributor.department University of Exeter (David Richards - at the time of publication, the author was at the University of York) en_GB
dc.date.accessioned 2008-12-19T12:33:44Z en_GB
dc.date.accessioned 2011-01-25T12:00:49Z en_US
dc.date.accessioned 2013-03-20T14:55:20Z
dc.date.issued 2007-02 en_GB
dc.description.abstract Background. 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. en_GB
dc.identifier.citation Psychological Medicine, 2007, 37(9): pp. 1217-1228. en_GB
dc.identifier.doi 10.1017/S0033291707000062 en_GB
dc.identifier.uri http://hdl.handle.net/10036/46773 en_GB
dc.language.iso en en_GB
dc.publisher Cambridge University Press en_GB
dc.relation.url http://journals.cambridge.org/action/displayJournal?jid=PSM en_GB
dc.subject Self-help interventions en_GB
dc.subject Depression en_GB
dc.title What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. en_GB
dc.type Article en_GB
dc.date.available 2008-12-19T12:33:44Z en_GB
dc.date.available 2011-01-25T12:00:49Z en_US
dc.date.available 2013-03-20T14:55:20Z
dc.identifier.issn 0033-2917 en_GB
dc.description Reproduced with permission of the publisher. © 2007 Cambridge University Press. en_GB
dc.identifier.eissn 1469-8978 en_GB
dc.identifier.journal Psychological Medicine en_GB


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