The clinical and cost-effectiveness of self-help treatments for anxiety and depressive disorders in primary care: a systematic review

Anxiety and depression are prevalent in primary care,. however current trea tments differ in their availability g cost-effectiveness, and acceptability to patients. Self-help treatments (such as manual-based bibliotherapy) may be an appropriate intervention for some patients. The aim of this research was to determine the clinical and cost-effectiveness of self-help treatmen ts for anxiety and depression in primary care by conducting a systematic re view of randomised and non-randomised trials of self-help interventions for patients with anxiety and depression in primary care,,from electronic data base searches, correspondence with authors, and limited handsearching. Eigh t studies were identified, examining written interventions based mostly on behavioural principles. Although the majority of trials reported some signi ficant advantages in outcome associated with self-help treatments, the numb er of included studies was limited and a number of methodological limitatio ns were identified. There were no data concerning long-term clinical benefi ts or cost-effectiveness. in conclusion, self-help treatments may have the potential to improve the overall cost-effectiveness of mental health servic e provision. However the available evidence is limited in quanti v and qual ity and more rigorous trials are required to provide more reliable estimate s of the clinical and cost-effectiveness of these treatments.