Influence of initial severity of depression on effectiveness of low intensity interventions: meta-analysis of individual patient data

Publikation: Beiträge in ZeitschriftenZeitschriftenaufsätzeForschungbegutachtet

Authors

  • P. Bower
  • E. Kontopantelis
  • A. Sutton
  • T. Kendrick
  • D. Richards
  • S. Gilbody
  • S. Knowles
  • Pim Cuijpers
  • Gerhard Andersson
  • Helen M. Christensen
  • B. Meyer
  • Marcus Huibers
  • Filip Smit
  • Annemieke Van Straten
  • L. Warmerdam
  • Michael Barkham
  • Linda Bilich
  • Karina Lovell
  • Emily Tung-Hsueh Liu
Objective To assess how initial severity of depression affects the benefit derived from low intensity interventions for depression.

Design Meta-analysis of individual patient data from 16 datasets comparing low intensity interventions with usual care.

Setting Primary care and community settings.

Participants 2470 patients with depression.

Interventions Low intensity interventions for depression (such as guided self help by means of written materials and limited professional support, and internet delivered interventions).

Main outcome measures Depression outcomes (measured with the Beck Depression Inventory or Center for Epidemiologic Studies Depression Scale), and the effect of initial depression severity on the effects of low intensity interventions.

Results Although patients were referred for low intensity interventions, many had moderate to severe depression at baseline. We found a significant interaction between baseline severity and treatment effect (coefficient −0.1 (95% CI −0.19 to −0.002)), suggesting that patients who are more severely depressed at baseline demonstrate larger treatment effects than those who are less severely depressed. However, the magnitude of the interaction (equivalent to an additional drop of around one point on the Beck Depression Inventory for a one standard deviation increase in initial severity) was small and may not be clinically significant.

Conclusions The data suggest that patients with more severe depression at baseline show at least as much clinical benefit from low intensity interventions as less severely depressed patients and could usefully be offered these interventions as part of a stepped care model.
OriginalspracheEnglisch
Aufsatznummerf540
ZeitschriftThe BMJ (Clinical research ed.)
Jahrgang346
Ausgabenummer7899
Anzahl der Seiten11
ISSN0959-8138
DOIs
PublikationsstatusErschienen - 26.02.2013

Dokumente

DOI

Zuletzt angesehen

Publikationen

  1. Differences in the sophistication of Value-based Management
  2. Machine vision system errors for unmanned aerial vehicle navigation
  3. Detection of significant tracer gases by means of polymer gas sensors
  4. Improve a 3D distance measurement accuracy in stereo vision systems using optimization methods’ approach
  5. Visual-Inertial Navigation Systems and Technologies
  6. Defining the notion of mining, extraction and collection
  7. Adaptive capacity and learning to learn as leverage for social-ecological resilience
  8. 2. Advent
  9. Investigation and prediction of grain texture evolution in AA6082
  10. Adaptor device for transmitting e.g. blood pressure data of human body from blood pressure measuring device of data communication system to e.g. personal computer, has controller for controlling transmission of data to communication module
  11. Digital Business Transformation and the Changing Role of the IT Function
  12. The Economic Value of Clickstream Data From an Advertiser's Perspective
  13. Modeling and simulation of the microstructural behaviour in thermal sprayed coatings
  14. Instruments for research on transition. Applied methods and approaches for exploring the transition of young care leavers to adulthood
  15. Swarm Robotics, or: the smartness of 'a bunch of cheap dumb things'
  16. Complementing AAI at the meso level
  17. Biological Computer Laboratory
  18. Case study: The development of a multi-material heat sink by Additive Manufacturing using Aerosint technology
  19. Temporal Dynamics of Ecosystem Services
  20. Diversity of Play
  21. Marine biodiversity change impacts relational values
  22. Motivation for the Continuation of Work
  23. Basic analysis of the incremental profile forming process
  24. Understanding Context Collapse for Social Media Users
  25. Priority effects of time of arrival of plant functional groups override sowing interval or density effects
  26. Joint extremal behavior of hidden and observable time series with applications to GARCH processes
  27. The creation and analysis of employer-employee matched data, ed. by John C. Haltiwanger ...
  28. Automated Fabrication of Elastomeric Prepregs for Soft Robotics Applications
  29. Class size, student performance and Tiebout bias
  30. Examining how AI capabilities can foster organizational performance in public organizations
  31. Papers from the 10th Lancaster University Postgraduate Conference in Linguistics and Language Teaching 2015
  32. The Influence of Tree Diversity on Natural Enemies—a Review of the “Enemies” Hypothesis in Forests
  33. Systems Engineering in Public Administration
  34. Parameters, concepts and the terminology of outer space law: a review of the essential facilities served by outer space activities and the rules of interpretation for treaty law and soft law guidelines.