Psychoeducation for depression, anxiety and psychological distress: a meta-analysis

BackgroundGiven the high prevalence and burden associated with depression and anxiety disorders and the existence of treatment barriers, there is a clear need for brief, inexpensive and effective interventions such as passive psychoeducational interventions. There are no published meta-analyses of the effectiveness of passive psychoeducation in reducing symptoms of depression, anxiety or psychological distress.MethodsCochrane, PsycInfo and PubMed databases were searched in September 2008. Additional materials were obtained from reference lists. Papers describing passive psychoeducational interventions for depression, anxiety and psychological distress were included if the research design was a randomized controlled trial and incorporated an attention placebo, no intervention or waitlist comparison group.ResultsIn total, 9010 abstracts were identified. Of these, five papers which described four research studies targeting passive psychoeducation for depression and psychological distress met the inclusion criteria. The pooled standardized-effect size (four studies, four comparisons) for reduced symptoms of depression and psychological distress at post-intervention was d = 0.20 (95% confidence interval: 0.01-0.40; Z = 2.04; P = 0.04; the number needed to treat: 9). Heterogeneity was not significant among the studies (I2 = 32.77, Q:4.46; P = 0.22).ConclusionsAlthough it is commonly believed that psychoeducation interventions are ineffective, this meta-analysis revealed that brief passive psychoeducational interventions for depression and psychological distress can reduce symptoms. Brief passive psychoeducation interventions are easy to implement, can be applied immediately and are not expensive. They may offer a first-step intervention for those experiencing psychological distress or depression and might serve as an initial intervention in primary care or community models. The findings suggest that the quality of psychoeducation may be important.

[1]  M. Sajatovic,et al.  Enhancement of treatment adherence among patients with bipolar disorder. , 2004, Psychiatric services.

[2]  E. Hoffman,et al.  Anxiety disorders: a comprehensive review of pharmacotherapies. , 2008, The Mount Sinai journal of medicine, New York.

[3]  F. Scogin,et al.  Comparative efficacy of cognitive and behavioral bibliotherapy for mildly and moderately depressed older adults. , 1989, Journal of consulting and clinical psychology.

[4]  D. Bhugra,et al.  A Randomised Controlled Trial of an Educational Intervention for Depression among Asian Women in Primary Care in the United Kingdom , 2002, The International journal of social psychiatry.

[5]  Josep Corominas,et al.  A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission. , 2003, Archives of general psychiatry.

[6]  M. Larimer,et al.  A randomized clinical trial of a brief, mailed intervention for symptoms of depression. , 2006, Journal of consulting and clinical psychology.

[7]  Z. Rihmer,et al.  Psychotherapeutic intervention and suicide risk reduction in bipolar disorder: a review of the evidence. , 2009, Journal of affective disorders.

[8]  J. Calabrese,et al.  Intensive psychosocial intervention enhances functioning in patients with bipolar depression: results from a 9-month randomized controlled trial. , 2007, The American journal of psychiatry.

[9]  Blair T. Johnson,et al.  Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration , 2008, PLoS medicine.

[10]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[11]  L. Hedges,et al.  Meta-analysis of screening and diagnostic tests. , 1995, Psychological bulletin.

[12]  R. Churchill,et al.  Psychological therapies for generalised anxiety disorder. , 2007, The Cochrane database of systematic reviews.

[13]  P. Cuijpers,et al.  Curbing problem drinking with personalized-feedback interventions: a meta-analysis. , 2009, American journal of preventive medicine.

[14]  Kurt P Spindler,et al.  How to Write a Systematic Review , 2007, Clinical orthopaedics and related research.

[15]  G. Andersson,et al.  Treatment of social phobia: randomised trial of internet-delivered cognitive-behavioural therapy with telephone support , 2007, British Journal of Psychiatry.

[16]  N. Kawakami,et al.  Effects of mailed advice on stress reduction among employees in Japan: a randomized controlled trial. , 1999, Industrial health.

[17]  H. Christensen,et al.  Delivering interventions for depression by using the internet: randomised controlled trial , 2004, BMJ : British Medical Journal.

[18]  J. Docherty Barriers to the diagnosis of depression in primary care. , 1997, The Journal of clinical psychiatry.

[19]  D. Sackett,et al.  Evidence based medicine: what it is and what it isn't , 1996, BMJ.

[20]  G. Clum,et al.  A comparison of bibliotherapy and group therapy in the treatment of panic disorder. , 1994, Journal of consulting and clinical psychology.

[21]  K. Griffiths,et al.  Providing information about the effectiveness of treatment options to depressed people in the community: a randomized controlled trial of effects on mental health literacy, help-seeking and symptoms , 2003, Psychological Medicine.

[22]  P. Cuijpers,et al.  Economic costs of minor depression: a population‐based study , 2007, Acta psychiatrica Scandinavica.

[23]  P. Cuijpers,et al.  Minor depression: risk profiles, functional disability, health care use and risk of developing major depression. , 2004, Journal of affective disorders.

[24]  A R Jadad,et al.  Assessing the quality of reports of randomized clinical trials: is blinding necessary? , 1996, Controlled clinical trials.

[25]  H. Christensen,et al.  Comparative randomised trial of online cognitive–behavioural therapy and an information website for depression: 12-month outcomes , 2008, British Journal of Psychiatry.

[26]  S Duval,et al.  Trim and Fill: A Simple Funnel‐Plot–Based Method of Testing and Adjusting for Publication Bias in Meta‐Analysis , 2000, Biometrics.

[27]  P. Cuijpers,et al.  Bibliotherapy in unipolar depression: a meta-analysis. , 1997, Journal of behavior therapy and experimental psychiatry.

[28]  S. Merry,et al.  Psychological and/or educational interventions for the prevention of depression in children and adolescents. , 2004, The Cochrane database of systematic reviews.

[29]  A J Fyer,et al.  Treatment of Panic Disorder , 1981, Journal of clinical psychopharmacology.

[30]  D. Altman,et al.  Measuring inconsistency in meta-analyses , 2003, BMJ : British Medical Journal.

[31]  David J. Kupfer,et al.  Size of Treatment Effects and Their Importance to Clinical Research and Practice , 2006, Biological Psychiatry.