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Effectiveness of a psycho-educational group program for major depression in primary care a randomized controlled trial.doc

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Effectiveness of a psycho-educational group program for major depression in primary care a randomized controlled trial

Casa?asetal.BMCPsychiatry2012,12:230 /1471-244X/12/230 RESEARCH ARTICLE OpenAccess Effectivenessofapsycho-educationalgroup programformajordepressioninprimarycare: arandomizedcontrolledtrial RocíoCasa?as1,2,3,RosaCatalán4,5,6,7*,JoseLuisdelVal3,JordiReal3,SergiValero7,8andMiquelCasas7,8 Abstract Background:Studiesshowtheeffectivenessofgrouppsychoeducationinreducingsymptomsinpeoplewith depression.However,fewcontrolledstudiesthathaveincludedaspectsofpersonalcareandhealthylifestyle (diet,physicalexercise,sleep)togetherwithcognitive-behavioraltechniquesinpsychoeducationareproventobe effective. Theobjectiveofthisstudyistoassesstheeffectivenessofapsychoeducationalprogram,whichincludesaspectsof personalcareandhealthylifestyle,inpatientswithmild/moderatedepressionsymptomsinPrimaryCare(PC). Methods:Inarandomized,controlledtrial,246participantsover20yearsoldwithICD-10majordepressionwere recruitedthroughnurses/generalpractitionersat12urbanPrimaryCareCenters(PCCs)inBarcelona.The interventiongroup(IG)(n=119)receivedagrouppsychoeducationalprogram(12weekly,1.5hsessionsledbytwo nurses)andthecontrolgroup(CG)(n=112)receivedusualcare.Patientswereassessedatbaselineandat,3,6and 9months.ThemainoutcomemeasuresweretheBDI,EQ-5DandremissionbasedupontheBDI. Results:231randomizedpatientswereincluded,ofwhom85hadmilddepressionand146moderatedepression. Theanalysesshowedsignificantdifferencesbetweengroupsinrelationtoremissionofsymptoms,especiallyinthe milddepressiongroupwithahighrateof57%(p=0.009)atpost-treatmentand65%(p=0.006)at9monthfollow up,andonlyshowedsignificantdifferencesontheBDIatpost-treatment(p=0.016;effectsizeCohen’sd’=.51)and at6and9monthfollow-up(p=0.048;d’=.44). Intheoverallandmoderatesample,theanalysesonlyshowedsignificantdifferencesbetweengroupsontheBDIat post-treatment,p=0.02(d’=.29)andp=0.010(d’=.47),respectively. ThepsychoeducationgroupimprovedsignificantlyontheEQ-5Datshortandlong-term. Conclusions:Thispsychoeducationalinterventionisashortandlong-termeffectivetreatmentforpati