title: A systematic review of non-pharmacological treatments for depression in people with chronic physical health problems.
abstract: OBJECTIVE
  To review the efficacy of non-pharmacological treatment for depression in people with depression and chronic physical health problems.
  
  
  METHODS
  Five electronic databases were searched including EMBASE, Medline and PsycINFO for randomized controlled trials (RCTs). Each paper was assessed for quality, data extracted and, where possible, the data meta-analyzed. The overall quality of each meta-analysis was assessed.
  
  
  RESULTS
  35 studies met our inclusion criteria and 22 were meta-analyzed using a random-effects model. The largest and strongest evidence base supports individual- and group-based cognitive and behavioral interventions (18 trials). The evidence was strongest for those interventions aimed solely at reducing depression in comparison to those aimed more broadly at reducing the psychosocial stress associated with having a chronic physical health problem.
  
  
  CONCLUSIONS
  Overall, the efficacy of certain types of non-pharmacological interventions for people with depression and chronic physical health problems has been demonstrated. The overall impression is that their efficacy in this population is comparable to that in people with depression without chronic physical health problems but the evidence-base is currently inadequate and larger trials with long-term follow-up are required.
authors.affiliation: National Collaborating Centre for Mental Health, United Kingdom. maria.rizzo@matrixknowledge.com
authors.forename: Maria
authors.initials: M
authors.lastname: Rizzo
authors.forename: Francis
authors.initials: F
authors.lastname: Creed
authors.forename: David
authors.initials: D
authors.lastname: Goldberg
authors.forename: Nicholas
authors.initials: N
authors.lastname: Meader
authors.forename: Stephen
authors.initials: S
authors.lastname: Pilling
mesh_terms: D002908:Chronic Disease; D003866:Depressive Disorder / Q000628:therapy*; D006304:Health Status; D006801:Humans; D011613:Psychotherapy; D013315:Stress, Psychological / Q000628:therapy*; D016896:Treatment Outcome