%0 Journal Article
%T Brief psychological therapies for anxiety and depression in primary care: meta-analysis and meta-regression
%A John Cape
%A Craig Whittington
%A Marta Buszewicz
%A Paul Wallace
%A Lisa Underwood
%J BMC Medicine
%D 2010
%I BioMed Central
%R 10.1186/1741-7015-8-38
%X Meta-analysis and meta-regression of randomized controlled trials of brief psychological therapies of adult patients with anxiety, depression or mixed common mental health problems treated in primary care compared to primary care treatment as usual.Thirty-four studies, involving 3962 patients, were included. Most were of brief cognitive behaviour therapy (CBT; n = 13), counselling (n = 8) or problem solving therapy (PST; n = 12). There was differential effectiveness between studies of CBT, with studies of CBT for anxiety disorders having a pooled effect size [d -1.06, 95% confidence interval (CI) -1.31 to -0.80] greater than that of studies of CBT for depression (d -0.33, 95% CI -0.60 to -0.06) or studies of CBT for mixed anxiety and depression (d -0.26, 95% CI -0.44 to -0.08). Counselling for depression and mixed anxiety and depression (d -0.32, 95% CI -0.52 to -0.11) and problem solving therapy (PST) for depression and mixed anxiety and depression (d -0.21, 95% CI -0.37 to -0.05) were also effective. Controlling for diagnosis, meta-regression found no difference between CBT, counselling and PST.Brief CBT, counselling and PST are all effective treatments in primary care, but effect sizes are low compared to longer length treatments. The exception is brief CBT for anxiety, which has comparable effect sizes.Anxiety and depressive disorders are common, with estimated combined prevalence varying between countries but over 10% in most Western countries [1-4]. The majority of such patients are treated in primary care, with few patients referred on to secondary mental health services [5,6].With access to psychological therapies being limited [7], psychological therapy provided within primary care settings for depression and anxiety is usually brief [8]. In the UK, six sessions is a common treatment length [9]. This contrasts to the treatment lengths of 12 - 24 sessions which have been the subject of most efficacy trials of psychological therapies in secondary care setting
%U http://www.biomedcentral.com/1741-7015/8/38