Study designs of evaluations included in the review
Randomised controlled trials (RCTs) were eligible for inclusion.
Specific interventions included in the review
Studies of self-help manuals were eligible for inclusion. In the review, self-help manuals were defined as booklets or manuals aimed at improving anxiety disorders and designed to be used either by the patient alone or with limited contact with a therapist. The included studies used interventions lasting 1 to 3 months and compared self-help manuals with a health education leaflet, waiting list, usual care, advice and manual plus varying levels of contact and cognitive-behavioural therapy (CBT).
Participants included in the review
Studies of patients with anxiety disorders in primary care were eligible for inclusion. The review focused on panic disorder and generalised anxiety disorder. Studies in patients with a mix of anxiety and depressive disorders were excluded unless the results were presented separately for the anxiety subgroup. The included studies diagnosed patients with anxiety, anxiety disorder, phobic avoidance or panic disorder (in one study some patients also had agoraphobia) using the American Psychiatric Association's DSM III or III-R criteria (3 studies) or the Zung Anxiety scale (1 study); two studies gave no details. The duration of anxiety varied among the studies (where reported).
Outcomes assessed in the review
Studies that assessed effectiveness were eligible for inclusion. The measures used to assess the outcomes in the primary studies included the State Trait Anxiety Inventory, Symptom Checklist 90, Hospital Anxiety and Depression Scale, and Global Symptom Severity.
How were decisions on the relevance of primary studies made?
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.