Study designs of evaluations included in the review
Randomised controlled trials (RCTs) carried out in the United Kingdom in general practices, in which a psychological treatment was compared with another active intervention or with 'usual treatment'.
Specific interventions included in the review
Generic counselling (Rogerian non-directive or unspecified), of 6 to 14 sessions in duration, or duration unspecified. Cognitive therapy and social work interventions were also included. The control groups received another active treatment or 'treatment as usual'.
Participants included in the review
The initial inclusion criteria included patients with depression, as diagnosed by their general practitioner (GP). Studies of postnatal depression, depression in the elderly, co-morbid depressive disorders, psychiatric depression, or bipolar affective disorders were excluded.
No studies were found using the a priori inclusion criteria, and consequently the review changed to focus on two indirect evaluations of the topic. Hence, in the generic counselling groups, the participants were aged at least 16 years and had social, psychological or emotional problems, excluding serious psychiatric morbidity. In the cognitive therapy groups, the participants were aged between 18 and 65 years and fulfilled either the Research Diagnostic Criteria or DSM-III-R Criteria for major depressive disorder.
Outcomes assessed in the review
The outcome measures were: psychotropic prescribing, GP consultation rate, subjective improvement, General Health Questionnaire, external referrals, patient self-assessment, Beck depression inventory, brief symptom inventory, revised clinical interview schedule, modified social adjustment scale, repertory grids, Hospital Anxiety and Depression Scale, Dartmouth COOP Charts, delighted-terrible faces scales, Hamilton Rating Scale for Depression, Montgomery-Asberg Depression Scale, and American Psychiatric Association DSM-III-R.
How were decisions on the relevance of primary studies made?
The authors do not state how the papers were selected for the review, or how many of the authors performed the selection.