Depression in adults: psychological treatments and care pathways.
BACKGROUND
Depression may affect up to 10% of the population, with symptoms recurring in half of affected people. In mild to moderate depression, there is no reliable evidence that any one treatment is superior in improving symptoms of depression, but the strength of evidence supporting different treatments varies.


METHODS
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of psychological treatments, and of interventions to reduce relapse rates, in mild to moderate or severe depression? What are the effects of psychological interventions to improve delivery of treatments in mild to moderate or severe depression? We searched: Medline, Embase, The Cochrane Library and other important databases up to April 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found 55 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: befriending, care pathways, cognitive therapy, combining antidepressant drugs and psychological treatments, interpersonal psychotherapy, non-directive counselling, problem-solving therapy, relapse prevention programme.
Price
Jonathan
J
University of Oxford, Oxford, UK.
Butler
Rob
R
Hatcher
Simon
S
Von Korff
Michael
M
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003863:Depression; D003866:Depressive Disorder / Q000188:drug therapy; D003865:Major Depressive Disorder / Q000175:diagnosis; D019317:Evidence-Based Medicine; D006801:Humans; D011613:Psychotherapy; D016896:Treatment Outcome
D000928:Antidepressive Agents