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Clin Psychol Rev. 2014 Mar;34(2):141-57. doi: 10.1016/j.cpr.2014.01.005. Epub 2014 Jan 23.

Self-help interventions for symptoms of depression, anxiety and psychological distress in patients with physical illnesses: a systematic review and meta-analysis.

Author information

  • 1Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK. Electronic address: faith.matcham@kcl.ac.uk.
  • 2Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK.
  • 3South London and Maudsley NHS Foundation Trust, UK; King's College Hospital NHS Foundation Trust, UK.

Abstract

Psychological distress, depression and anxiety are common in most physical diseases, and self-help interventions, if effective, might be an important approach to improve outcomes as they are inexpensive to provide to large numbers of patients. The primary aim of this review was to assess randomised controlled trials examining the impact of self-help interventions on symptoms of depression, anxiety and psychological distress in patients with physical illness. Systematic searches of electronic databases resulted in twenty-five eligible studies for meta-analysis (n=4211). The results of the primary meta-analyses revealed a significant improvement in depression symptoms, in favour of the intervention group (SMD=-0.13, 95% CI: -0.25, -0.02, p=0.02, I(2)=50%). There were no significant differences in symptoms of anxiety (SMD=-0.10, 95% CI: -0.24, 0.05, p=0.20, I(2)=63%) or psychological distress (SMD=-0.14, 95% CI: -0.40, 0.12, p=0.30, I(2)=72%) between intervention and control conditions. Several subgroup and sensitivity analyses improved effect sizes, suggesting that optimal mental health outcomes may be obtained in patients without neurological conditions, and with interventions based on a therapeutic model (such as cognitive behavioural therapy), and with stress management components. This review demonstrates that with appropriate design and implementation, self-help interventions may potentially improve symptoms of depression in patients with physical conditions.

Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

KEYWORDS:

Mental health; Meta-analysis; Physical illness; Randomised controlled trial; Self-help

PMID:
24508685
[PubMed - indexed for MEDLINE]
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