Peer Support Beats Usual Care for Depression, Analysis Finds
Posted Feb 23 2011 12:53am
But it may not be helpful for people with severe depression, one expert suggests
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By Randy Dotinga
Friday, February 18, 2011
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FRIDAY, Feb. 18 (HealthDay News) -- A new analysis of existing research finds that peer support may do a better job of treating depression than standard care.
Depression is difficult to treat even with the help of psychotherapy and antidepressant drugs. According to the analysis, one-third of depressed patients have significant symptoms even after being treated with four different medications. In addition, among depressed people who recover while taking antidepressant drugs, more than half relapse within a year.
The researchers looked at 14 studies involving depression and peer support in their meta-analysis, which is a method that pools the results of different studies examining a common problem so they can be analyzed statistically. All of the studies had randomly assigned depressed people to receive peer support with at least one other person, or one of three other types of treatment including standard care, cognitive behavioral therapy, or both. The studies examined the experiences of 869 participants in total.
The researchers combined the results of the studies and reported their findings online in advance of publication in an upcoming print issue of the journal General Hospital Psychiatry.
Dr. Paul Pfeiffer, an assistant professor of psychiatry at the University of Michigan Medical School in Ann Arbor, and colleagues found that support groups were "superior" to regular care but didn't do significantly better or worse than cognitive behavioral therapy, which trains people to develop new patterns of thought and behavior.
Why might support groups be so helpful? Pfeiffer's team suggested that it may have something to do with their ability to lessen isolation, provide a buffer against stressful events, help patients share health information and offer role models. "Peer support programs may also empower patients to play a more active role in their own self-care," they wrote.
"Given the high level of functional burden imposed by depression worldwide, peer support for depression should also be studied as a potentially low-cost intervention in primary care or other settings where more established but costly depression services are unavailable," the authors concluded.
One expert who was not involved with the meta-analysis had some criticisms of the findings.
Dr. Bernard Carroll, scientific director at the Pacific Behavioral Research Foundation and past chairman of psychiatry at Duke University, said that several of the studies in the review were weak, and the stronger ones showed the treatment approaches were just about equally effective. In addition, some of the studies focused on people with mild symptoms, he noted.
But peer support might still have its uses in depression treatment, he noted.
Overall, Carroll said, the review suggested that peer support "may be somewhat helpful" -- with caveats -- in certain people without severe symptoms of depression.
SOURCES: Bernard Carroll, Ph.D., scientific director, Pacific Behavioral Research Foundation, Carmel, Calif.; Nov. 13, 2010, General Hospital Psychiatry, online
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