title: Collaborative care for depression in European countries: a systematic review and meta-analysis.
abstract: OBJECTIVE
  This is a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effectiveness of collaborative care compared to Primary Care Physician's (PCP's) usual care in the treatment of depression, focusing on European countries.
  
  
  METHODS
  A systematic review of English and non-English articles, from inception to March 2014, was performed using database PubMed, British Nursing Index and Archive, Ovid Medline (R), PsychINFO, Books@Ovid, PsycARTICLES Full Text, EMBASE Classic+Embase, DARE (Database of Abstract of Reviews of Effectiveness) and the Cochrane Library electronic database. Search term included depression, collaborative care, physician family and allied health professional. RCTs comparing collaborative care to usual care for depression in primary care were included. Titles and abstracts were independently examined by two reviewers, who extracted from the included trials information on participants' characteristics, type of intervention, features of collaborative care and type of outcome measure.
  
  
  RESULTS
  The 17 papers included, regarding 15 RCTs, involved 3240 participants. Primary analyses showed that collaborative care models were associated with greater improvement in depression outcomes in the short term, within 3 months (standardized mean difference (SMD) -0.19, 95% CI=-0.33; -0.05; p=0.006), medium term, between 4 and 11 months (SMD -0.24, 95% CI=-0.39; -0.09; p=0.001) and medium-long term, from 12 months and over (SMD -0.21, 95% CI=-0.37; -0.04; p=0.01), compared to usual care.
  
  
  CONCLUSIONS
  The present review, specifically focusing on European countries, shows that collaborative care is more effective than treatment as usual in improving depression outcomes.
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Sighinolfi
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Nespeca
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. Electronic address: marco.menchetti3@unibo.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Menchetti
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Levantesi
authors.affiliation: Department of Neuroscience, University of Genova, Genova, Italy.
authors.forename: Martino
authors.initials: M
authors.lastname: Belvederi Murri
authors.affiliation: Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Berardi
mesh_terms: D000328:Adult; D003863:Depression / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy*; D005060:Europe; D006801:Humans; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D011320:Primary Health Care / Q000379:methods / Q000592:standards / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: Collaborative care; Depression; Meta-analysis; Primary care; Primary care physician; Usual care