Skip to main content

Table 4 Recovery results of system intervention trials.

From: A systematic review of complex system interventions designed to increase recovery from depression in primary care

1st Author and Date Follow-up Times and Attrition Measures of Recovery and Recovery Results
Katon 1996 & Lin 1999. • F/U at 1, 4, 7 & 19 mths.
• Attrition# at 4 mths: UC = 14/76* (18.4%*), I = 11/77* (14.3%*)
• RA's completing F/U were blind to intervention status.
Recovery = Proportion with 1 or less symptoms of depression on the Inventory for Depressive Symptomatology (IDS). Recovery was only reported for sub-groups in the article (people with Major depression vs Minor depression). Usual Care and Intervention data were deduced from sub-group data provided.
• At 4 mths: UC = 35/62* (56%*), I = 45/66* (68%*). No statistical comparisons were provided.
Mann 1998. • F/U at 4 mths.
• Attrition: UC = 14/148 (9.5%), I = 20/271 (7.4%)
• RA's completing F/U were not blind to intervention status.
Recovery = Change in proportion not meeting DSM-III criteria for major depression on the Nurse Assessment Interview (NAI) from baseline to follow-up.
• At 4 mths: UC = 79/134* (59%*), I = 123/251* (49%*), ns.
Katon 1999. • F/U at 1, 3 & 6 mths.
• Attrition at 3 mths: UC = 17/114* (14.9%*), I = 18/114* (15.8%*)
• Attrition at 6 mths: UC = 17/114* (14.9%*), I = 19/114* (16.6%*)
• RA's completing F/U were blind to intervention status.
Recovery = Proportion with 1 or 0 symptoms of depression on the Structured Clinical Interview (SCID) for DSM-IV.
• At 3 months: UC = 22/97* (23%), I = 38/96* (40%), p = .01
• At 6 months: UC = 30/97* (31%), I = 42/95* (44%), p = .05
Katzelnick 2000. • F/U at 6 wks, 3, 6 & 12 mths.
• Attrition at 12 mths: UC = 12/189 (6.3%), I = 15/218 (6.9%).
• RA's completing F/U were blind to intervention status.
Recovery = Proportion with Hamilton Depression Rating Scale (HDRS) < 7.
• At 12 mths: UC = 49/177 (27.7%), I = 92/203 (45.3%), p < .001
• At 12 mths: Number to Treat = 5:1
Simon 2000. • F/U at 3 & 6 mths.
• Attrition not reported.
• RA's completing F/U were blind to intervention status.
Recovery = The inverse of odds ratios for meeting criteria for major depression on the Structured Clinical Interview (SCID) for DSM-IV.
• Across follow-ups, the Odds Ratio = 0.45 (0.24–0.86) indicates the probability of recovery was significantly higher in the Intervention group
Wells 2000 & Sherbourne 2001 & Wells 2004. • F/U at 6, 12, 24 & 57 mths.
• Attrition at 6 mths: UC = 57/443 (12.9%), I = 143/913 (15.7%).
• Attrition at 12 mths: UC = 69/443 (15.6%), I = 161/913 (17.6%).
• Attrition at 24 mths (estim.): UC = 65/443* (14.7%), I-Meds = 62/424* (14.7%), I-Therapy = 72/489* (14.7%)
• Attrition at 57 mths: UC = 131/443 (29.6%), I-Meds = 102/424 (24.0%), I-Therapy = 132/489 (27%)
• RA's completing F/U were not blind to intervention status.
Recovery = Proportion no longer meeting probable or persistent depression on the Composite International Diagnostic Interview (CIDI).
• At 6 mths, UC = 193/386* (50.1%*), I-Therapy & I-Meds combined = 463/770* (60.1%*), p = .005
• At 12 mths: UC = 183/374* (48.8*)%, I-Therapy & I-Meds combined = 439/752* (58.4%*), p = .04
• At 24 mths: UC = 223/338* (66%*) vs I-Meds = 221/362* (61%*), ns. UC = 223/338* (66%*) vs I-Therapy = 337/489* (69%*), ns
• At 57 mths: UC = 176/312* (56.4%*) vs I-Meds = 200/322* (62.1%*), ns. UC = 176/312* (56.4%*) vs I-Therapy = 228/357* (63.8%*), p = .05
Recovery = Proportion with Center for Epidemiologic Studies – Depression (CES-D, Modified version) < 20.
• At 6 mths: UC = 137/386* (35.6%), I-Therapy & I-Meds combined = 343/770* (44.6%*), p = .005
• At 12 mths: UC = 144/374* (38.6%), I-Therapy & I-Meds combined = 342/752* (45.5%*), p = .04
Rost 2001 & Smith 2002 & Rost 2002 • F/U at 6, 12, 18 & 24 mths.
• N = 479 were recruited to original trial (Rost 00). Smith 2002 and Rost 2002 are sub-group follow-ups.
• Smith 02: Attrition at 24 mths: UC = 48/195* (24.6%*), I = 70/188 (36.7%*).
• Rost 02: Attrition at 24 mths: UC = 13/96 (13.5%), I = 46/115 (40%)
• RA's completing F/U were blind to intervention status.
Smith 2002
Recovery = Proportion not meeting Composite International Diagnostic Interview (CIDI) criteria for major depression. Recovery was only reported for sub-groups in this article (uninsured vs insured, no significant difference was found). Usual Care and Intervention data were deduced from sub-group data provided.
• At 24 mths: UC = 113/148* (76.4%*), I = 92.5/119* (78%*).
Rost 2002
Recovery = Proportion of participants with Centre for Epidemiological Studies-Depression (CES-D) <16.
• At 24 mths: UC = 34/83* (41%) vs I = 51/69* (74%), p = .02
Datto 2003 • F/U at 16 weeks.
• Attrition at 16 weeks: UC = 5/31* (16.1%) vs I = 6/30* (20%)
• Unclear if nurses completing F/U were blind to intervention status.
Recovery = Proportion of participants with Centre for Epidemiological Studies-Depression (CES-D) <11.
• At 16 weeks: Odds Ratio = 3.48 (0.85–14.29), n.s (p = .08)
Recovery = Proportion of participants with CES-D<16
• At 16 weeks: Odds ratios = 6.58 (1.57–27.03), significant (p = .01) in favour of intervention
Recovery = Proportion of participants not meeting Mini-International Neuropsychiatric Interview (MINI) criteria for major depression.
• At 16 weeks: Odds ratio = 0.52 (0.13–2.03), n.s, p = .66
Finley 2003 • F/U at 6 mths
• Attrition: UC = 25/50 (50%) vs I = 16/75 (21%)
• F/U measures were completed by postal self-report questionnaires.
Recovery = Proportion of participants with Brief Inventory for Depressive Symptoms (BIDS) < 9
• At 6 mths UC = 14.6/25* (58.3%), I = 32.8/59* (55.6%), ns (p = .36)
Capoccia 2004 • F/U at 3, 6, 9 and 12 months.
• Attrition by Total N: At 3 mths = 3/74 (4%), At 6 & 9 mths = 4/74 (5%), At 12 mths = 5/74 (7%) (attrition was approximately equal in both groups)
• RA completing F/U was blind to intervention status.
Recovery = Proportion not meeting criteria for major depression on the Structured Clinical Interview (SCID) for DSM-IV and Symptom Checklist (SCL-20). Exact criteria/cut-offs were not specified.
• % with major depression did not differ significantly @ 3, 6, 9, 12 mths, p = .32.
• At 12 mths: Recovery deduced from data in article as: UC = 31/31* (100%*), I = 37/38* (97%*)
Dietrich 2004 • F/U at 3 & 6 months.
• Attrition at 3 mths: UC = 29/181 (16%) vs I = 39/224 (17%)
• Attrition at 6 mths: UC = 35/181 (19%) vs = 45/224 (20%)
• Interviewers completing F/U were blind to intervention status.
Remission = Proportion with Symptom Checklist (SCL-20) < 0.5.
• At 3 mths: UC = 25/152 (16.5%), I = 48/183 (26.2%), p = .018
• At 6 mths: UC = 39/146 (26.7%), I = 66/177 (37.3), p = .014
  1. * Figures (eg, n, percentages) were deduced from data in the article where indicated by an asterix. # Attrition rates were sometimes only reported for total subjects, rather than by arm of the trial.