Change search
CiteExportLink to record
Permanent link

Direct link
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Influence of initial severity of depression on effectiveness of low intensity interventions: meta-analysis of individual patient data
University of Manchester, England.
University of Manchester, England.
University of Leicester, England.
University of York, England.
Show others and affiliations
2013 (English)In: BMJ (Clinical Research Edition), ISSN 0959-8138, Vol. 346Article in journal (Refereed) Published
Abstract [en]

Objective To assess how initial severity of depression affects the benefit derived from low intensity interventions for depression.

Design Meta-analysis of individual patient data from 16 datasets comparing low intensity interventions with usual care.

Setting Primary care and community settings.

Participants 2470 patients with depression.

Interventions Low intensity interventions for depression (such as guided self help by means of written materials and limited professional support, and internet delivered interventions).

Main outcome measures Depression outcomes (measured with the Beck Depression Inventory or Center for Epidemiologic Studies Depression Scale), and the effect of initial depression severity on the effects of low intensity interventions.

Results Although patients were referred for low intensity interventions, many had moderate to severe depression at baseline. We found a significant interaction between baseline severity and treatment effect (coefficient −0.1 (95% CI −0.19 to −0.002)), suggesting that patients who are more severely depressed at baseline demonstrate larger treatment effects than those who are less severely depressed. However, the magnitude of the interaction (equivalent to an additional drop of around one point on the Beck Depression Inventory for a one standard deviation increase in initial severity) was small and may not be clinically significant.

Conclusions The data suggest that patients with more severe depression at baseline show at least as much clinical benefit from low intensity interventions as less severely depressed patients and could usefully be offered these interventions as part of a stepped care model.

Place, publisher, year, edition, pages
BMJ Publishing Group: BMJ , 2013. Vol. 346
National Category
Social Sciences
URN: urn:nbn:se:liu:diva-90762DOI: 10.1136/bmj.f540ISI: 000315669400021OAI: diva2:614688

Funding Agencies|UK National Institute of Health Research (NIHR) School for Primary Care Research||

Available from: 2013-04-08 Created: 2013-04-05 Last updated: 2017-12-06Bibliographically approved

Open Access in DiVA

fulltext(664 kB)