Publications: 2005 |
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McPherson, S., Cairns, P., Carlyle, J., Shapiro, D.A., Richardson, P., Taylor, D. (2005). The effectiveness of psychological treatments for treatment-resistant depression: A systematic review. Acta Psychiatrica Scandinavica, 111, 331-340. Objective: A systematic review of all studies (controlled and uncontrolled) to evaluate psychological interventions with treatment-resistant depression. Method: A systematic search to identify studiees evaluating a psychological intervention with adults with a diagnosis of major depressive disorder who had not responded to at least one course of antidepressant medication. Results: Twelve studies met inclusion criteria, of which four were controlled and eight uncontrolled. Treatment effect sizes were computable for four studies and ranged from 1.23 to 3.10 with a number of better quality studies demonstrating some improvements in patients following a psychological intervention. Conclusion: Psychological treatments for depression are commonly delivered and often recommended following the failure of medication. The paucity of evidence for their effectiveness in these situations is a significant problem. There is a need for studies with a strong controlled deesign investigating the effectiveness of psychological treatments for patients with treatment-resistant depression.
Barkham, M., Leach, C., Shapiro, D.A., Hardy, G.E., Lucock, M., & Rees, A. (2005). Rewiring efficacy studies to increase their relevance to routine practice. Mental Health and Learning Disabilities Research and Practice, 2, 11-18. Current efficacy literature relies heavily on the Beck Depression Inventory (BDI) as the gold standard patient self-report measure. In contrast, the evaluation of psychological therapies in routine practice relies heavily on the CORE-OM. Although the two measures are conceptually distinct, they have been shown to be highly correlated. This suggests the possibility of replacing one measure with the other -- a procedure we refer to as rewiring -- in service of making the results of efficacy studies using the BDI have greater relevance to practitioners who routinely use the CORE-OM. We tested this proposition using transformation tables (Leach et al., in press) to convert BDI-I scores into CORE-OM scores and reran the analysis of a major efficacy study of depression -- the Second Sheffield Psychotherapy Project (Shapiro et al., 1994). Results showed a near perfect replication of the original results and examples of benchmarks concerning the overall effects of treatment as well as differences between treatments are provided against which outcomes in routine practice can be contrasted. The implications for bridging efficacy and effectiveness research are discussed.
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