Key messages from scientific research that's ready to be acted on
Got It, Hide thisTwomey C, O`Reilly G, Byrne M Effectiveness of cognitive behavioural therapy for anxiety and depression in primary care: a meta-analysis. Fam Pract. 2015;32:3-15.
Is primary care–based cognitive–behavioural therapy (CBT) effective for treating anxiety and/or depression?
CBT is a therapy in which people learn about how their thinking may be inaccurate or overly negative, and that they can restructure their thinking and improve the way they respond to challenging situations.
CBT is known to be effective for treating anxiety and depression. Most of the research that shows that CBT is effective has assessed CBT provided by mental health specialists. However, recently, more primary care doctors (family doctors or general practitioners) have been providing CBT.
The researchers did a systematic review, based on studies published between 1997 and June 2014.
They found 29 randomized controlled trials with 4,736 people (average age 28 to 74 years). In these trials, 53% to 100% of the people were women.
The key features of the trials were:
Compared with no treatment or with usual primary care treatment, primary care–based CBT improved anxiety and depression by a small to medium amount.
Primary care–based CBT added to usual primary care treatment improved anxiety and depression by a small amount compared with usual primary care treatment alone.
Primary care–based cognitive–behavioural therapy improves anxiety and/or depression.
Type CBT | Comparator | Effect on anxiety and/or depression* |
Any type | No primary care treatment | Medium improvement in anxiety and/or depression (7 trials), anxiety alone (4 trials), or depression alone (3 trials) at 2 months after CBT |
Specific types | No primary care treatment | Medium improvement in anxiety and/or depression at 2 months after computerized/online CBT (3 trials) Small improvement in anxiety and/or depression at 2 months after guided self-help CBT (3 trials) |
Any type | Usual primary care treatment | Small improvement in anxiety and/or depression (14 trials), anxiety alone (3 trials), or depression alone (11 trials) at 4 months after CBT Medium improvement in anxiety and /or depression at 6 months after CBT (11 trials) |
Specific types | Usual primary care treatment | Small improvement in anxiety and/or depression at 5 months after face-to-face CBT (7 trials) or guided self-help CBT (4 trials) and at 2 months after computerized/online CBT (3 trials) |
Any type plus usual primary care | Usual primary care treatment | Small improvement in anxiety and/or depression at 4 months (9 trials) or 9 months (7 trials) after CBT |
Specific types plus usual primary care | Usual primary care treatment | Small improvement in depression at 4 months after face-to-face CBT plus usual primary care (5 trials) or at 6 months after computerized/online CBT plus usual primary care (3 trials) |