Since all studies were conducted in countries other than Sweden, and with other social and economic cultures, the value of the evidence may be difficult to apply to Swedish conditions. In most studies, adults with depression were treated. Only one study addressed children and adolescents, and one study addressed individuals with bipolar syndromes.
No studies were found on compulsory care in conjunction with psychotic conditions related to depression or mania, or studies which addressed ethical issues. Likewise, no studies were found concerning family members' experiences in living with individuals with depression, or caregivers' experiences and attitudes on caring for individuals with depression. Furthermore, no studies addressed cost-effectiveness and care organization related to the care of people with depression.
Only a few randomized studies (RCT) were found. Since these studies are recognized as having the highest scientific value when it comes to analyzing the effects of a particular intervention, it is essential that more studies become available. Mainly, the effects of different educational programs and different forms of support (eg, individual and group counseling and social training programs) should be assessed for both women and men. This is especially important since these program elements seem to play a particularly major and positive role in nursing care.
Another area which urgently needs to be addressed by rigorous nursing research concerns how families of depressed persons perceive their situation,how children of depressed family members perceive their situation, and the what type of nursing interventions are needed.