CoChat
Sign Up
Cited by 85Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

Self-help interventions for symptoms of depression, anxiety and psychological distress in patients with physical illnesses: A systematic review and meta-analysis

Open access
Matcham, F., Rayner, L., Hutton, J., Monk, A., Steel, C., Hotopf, M.·2014·Clinical Psychology Review
DOI 10.1016/j.cpr.2014.01.005
Open this paper in CoChat — free accountOpen PDF

Abstract

Psychological distress, depression and anxiety are common in most physical diseases, and self-help interventions, if effective, might be an important approach to improve outcomes as they are inexpensive to provide to large numbers of patients. The primary aim of this review was to assess randomised controlled trials examining the impact of self-help interventions on symptoms of depression, anxiety and psychological distress in patients with physical illness. Systematic searches of electronic databases resulted in twenty-five eligible studies for meta-analysis (n=4211). The results of the primary meta-analyses revealed a significant improvement in depression symptoms, in favour of the intervention group (SMD=-0.13, 95% CI: -0.25, -0.02, p=0.02, I(2)=50%). There were no significant differences in symptoms of anxiety (SMD=-0.10, 95% CI: -0.24, 0.05, p=0.20, I(2)=63%) or psychological distress (SMD=-0.14, 95% CI: -0.40, 0.12, p=0.30, I(2)=72%) between intervention and control conditions. Several subgroup and sensitivity analyses improved effect sizes, suggesting that optimal mental health outcomes may be obtained in patients without neurological conditions, and with interventions based on a therapeutic model (such as cognitive behavioural therapy), and with stress management components. This review demonstrates that with appropriate design and implementation, self-help interventions may potentially improve symptoms of depression in patients with physical conditions.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.cpr.2014.01.005

Cites

19 of 19 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A number of reviews demonstrate that self-help interventions are effective for depression and anxiety in adults.

    “A number of reviews demonstrate that self-help interventions are effective for depression and anxiety in adults.21,22”

    From Comparative efficacy and acceptability of bibliotherapy for depression and anxiety disorders in children and adolescents: a meta-analysis of randomized clinical trials (2018) · cites this paper as [21]

    The Discussion reports a small significant benefit for depression, but no significant overall benefit for anxiety. The Conclusions say theoretically based self-help materials may modestly improve both outcomes in patients with physical illness. That cautious, population-specific finding does not establish effectiveness for depression and anxiety in adults generally. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 47

  1. Aranda, S., Jefford, M., Yates, P., Gough, K., Seymour, J., Francis, P., et al. (2012). Impact of a novel nurse-led prechemotherapy education intervention (ChemoEd) on patient distress, symptom burden, and treatment-related information and support needs: Results from a randomised, controlled trial. Annals of Oncology, 23(1), 222-231.
  2. Barker-Collo, S. L., Feigin, V. L., Lawes, C. M., Parag, V., & Senior, H. (2010). Attention def- icits after incident stroke in the acute period: Frequency across types of attention and relationships to patient characteristics and functional outcomes. Topics in Stroke Rehabilitation, 17(6), 463-476.
  3. Barth, J., Schumacher, M., & Herrmann-Lingen, C. (2004). Depression as a risk factor for mortality in patients with coronary heart disease: A meta-analysis. Psychosomatic Medicine, 66(6), 802-813.
  4. Beatty, L. J., Koczwara, B., Rice, J., & Wade, T. D. (2010). A randomised controlled trial to evaluate the effects of a self-help workbook intervention on distress, coping and quality of life after breast cancer diagnosis. Medical Journal of Australia, 193(5), S68-S73.
  5. Boulanger, L., Zhao, Y., Bao, Y., & Russell, M. (2009). A retrospective study on the impact of comorbid depression or anxiety on healthcare resource use and costs among diabetic neuropathy patients. BMC Health Services Research, 9(1), 111.
  6. Boyd, C. M., & Fortin, M. (2010). Future of multimorbidity research: How should under- standing of multimorbidity inform health system design. Public Health Reviews, 32(2), 451-474.
  7. Chamberlain, D., Heaps, D., & Robert, I. (2008). Bibliotherapy and information prescrip- tions: A summary of the published evidence-base and recommendations from past and ongoing Books on Prescription projects. Journal of Psychiatric and Mental Health Nursing, 15(1), 24-36.
  8. De Lorenzo, F., Ballatori, E., Di Constanzo, F., Giacalone, A., Ruggeri, B., & Tirelli, U. (2004). Improving information to Italian cancer patients: Results of a randomized study. Annals of Oncology, 15(5), 721-725.
  9. DiMatteo, M., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 160(14), 2101-2107.
  10. Eames, S., Hoffmann, T., Worrall, L., Read, S., & Wong, A. (2011). Randomised controlled trial of a post-discharge education and support package for clients with stroke and their carers. International Journal of Stroke, 6, 8.
  11. Fors, E. A., Bertheussen, G. F., Thune, I., Juvet, L. K., Elvsaas, E.Ø., Oldervoll, L., et al. (2011). Psychosocial interventions as part of breast cancer rehabilitation programs? Results from a systematic review. Psycho-Oncology, 20(9), 909-918.
  12. Forster, A., Brown, L., Smith, J., House, A., Knapp, P., Wright, J. J., et al. (2012). Information provision for stroke patients and their caregivers. Cochrane Database of Systematic Reviews, 11. http://dx.doi.org/10.1002/14651858.CD001919.pub3. · DOI
  13. Frank, G., Johnston, M., Morrison, V., Pollard, B., & MacWalter, J. (2000). Perceived control and recovery from functional limitations: Preliminary evaluation of a workbook-based intervention for discharged stroke patients. British Journal of Health Psychology, 5(4), 413-420.
  14. Furze, G., Cox, H., Morton, V., Chuanh, L., Lewin, R. J. P., Nelson, P., et al. (2012). Random- ized controlled trial of a lay-facilitated angina management programme. Journal of Advanced Nursing, 68(10), 2267-2279.
  15. Furze, G., Dumville, J. C., Miles, J. N. V., Irvine, K., Thompson, D. R., & Lewin, R. J. P. (2009). "Prehabilitation" prior to CABG surgery improves physical functioning and depres- sion. International Journal of Cardiology, 132(1), 51-58.
  16. Galfin, J. M., Watkins, E. R., & Harlow, T. (2012). A brief guided self-help intervention for psychological distress in palliative care patients: A randomised controlled trial. Palliative Medicine, 26(3), 197-205.
  17. Garnefski, N., & Kraaij, V. (2012). Effects of a cognitive behavioral self-help program on emotional problems for people with acquired hearing loss: A randomized controlled trial. Journal of Deaf Studies and Deaf Education, 17(1), 75-84.
  18. Garnefski, N., Kraaij, V., & Schroevers, M. (2011). Effects of a cognitive behavioral self-help program on depressed mood for people with acquired chronic physical im- pairments: A pilot randomized controlled trial. Patient Education and Counseling, 85(2), 304-307.
  19. Gask, L. (2005). Overt and covert barriers to the integration of primary and specialist mental health care. Social Science & Medicine, 61(8), 1785-1794.
  20. Hackett, M. L., Carter, G., Crimmins, D., Clarke, T., Arblaster, L., Billot, L., et al. (2012). ImProving Outcomes after STroke (POST): Results from the randomized clinical pilot trial. International Journal of Stroke. http://dx.doi.org/10.1111/j.1747-4949.2012.00913.x. · DOI
  21. Haggemark, C., Bohman, L., Ilmoni-Brandt, K., Naslund, I., Sjoden, P. O., & Nilsson, B. (2001). Effects of information supply on satisfaction with information and quality of life in cancer patients receiving curative radiation therapy. Patient Education and Counseling, 45(3), 173-179.
  22. Higgins, J. P. T., Altman, D.G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A.D., et al. (2011). The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. British Medical Journal, 343. http://dx.doi.org/10.1136/bmj.d592. · DOI
  23. Hoffman, T., McKenna, K., Worrall, L., & Read, S. J. (2007). Randomised trial of a computer-generated tailored written education package for patients following stroke. Age and Ageing, 36(3), 280-286.
  24. Iconomou, G., Viha, A., Koutras, A., Koukourikou, I., Mega, V., Makatsoris, T., et al. (2006). Impact of providing booklets about chemotherapy to newly presenting patients with cancer: A randomized controlled trial. Annals of Oncology, 17(3), 515-520.
  25. Jones, C., Skirrow, P., Griffiths, R. D., Humphris, G. H., Ingleby, S., Eddleston, J., Waldmann, C., & Gager, M. (2003). Rehabilitation after critical illness: A randomized, controlled trial. Critical Care Medicine, 3(10), 2456-2461.
  26. Kennedy, A., Robinson, A., Hann, M., Thompson, D., Wilkin, D., & North-West Region Gastrointestinal Research Group (2003). A cluster-randomised controlled trial of a patient-centred guidebook for patients with ulcerative colitis: Effect on knowledge, anxiety and quality of life. Health & Social Care in the Community, 11(1), 64-72.
  27. Klee, M., Groenvold, M., & Machin, D. (1997). Quality of life of Danish women: Population-based norms for the EORTC QLQ-C30. Quality of Life Research, 6(1), 27-34.
  28. Knowles, R. E., & Tarrier, N. (2009). Evaluation of the effect of prospective patient diaries on emotional well-being in intensive care unit survivors: A randomized controlled trial. Critical Care Medicine, 37(1), 184-191.
  29. Kraaij, V., van Emmerik, A., Garnefski, N., Schroevers, M. J., Lo-Fo-Wong, D., van Empelen, P., et al. (2010). Effects of a cognitive behavioral self-help program and a computer- ized structured writing intervention on depressed mood for HIV-infected people: A pilot randomized controlled trial. Patient Education and Counseling, 80(2), 200-204.
  30. Krischer, M. M., Xu, P., Meade, C. D., & Jacobsen, P. B. (2007). Self-administered stress management training in patients undergoing radiotherapy. Journal of Clinical Oncology, 25(29), 4657-4662.
  31. Lewin, R. J. P., Furze, G., Robinson, J., Griffith, K., Wiseman, S., Pye, M., et al. (2002). A randomised controlled trial of a self-management plan for patients with newly diag- nosed angina. British Journal of General Practice, 52(476), 194-201.
  32. Lewin, R. J. P., Thompson, D. R., Martin, C. R., Stuckey, N., Devlen, J., Michaelson, S., et al. (2002). Validation of the cardiovascular limitations and symptoms profile (CLASP) in chronic stable angina. Journal of Cardiopulmonary Rehabilitation and Prevention, 22(3), 184-191.
  33. Mant, J., Carter, J., Wade, D. T., & Winner, S. (1998). The impact of an information pack on patients with stroke and their carers: A randomized controlled trial. Clinical Rehabilitation, 12(6), 465-476.
  34. McGeoch, G. R. B., Willsman, K. J., Dowson, C. A., Town, G. I., Frampton, C. M., McCartin, F. J., et al. (2006). Self-management plans in the primary care of patients with chronic obstructive pulmonary disease. Respirology, 11(5), 611-618.
  35. Miller, S. M. (1987). Monitoring and blunting: Validation of a questionnaire to assess styles of information seeking under threat. Journal of Personality and Social Psychology, 52(2), 345-353.
  36. Moher, D., Alessandro, L., Tetszlaff, J., & Altman, D.G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine, 151(4), 264-269.
  37. Moher, D. C., Hart, S. L., Julian, L., Catledge, C., Honos-Webb, L., Vella, L., et al. (2005). Telephone-administered psychotherapy for depression. Archives of General Psychiatry, 62(9), 1007-1014.
  38. Munafò, M. R., & Flint, J. (2004). Meta-analysis of genetic association studies. Trends in Genetics, 20(9), 439-444.
  39. Patel, M.D., Coshall, C., Rudd, A. G., & Wolfe, C. D. A. (2002). Cognitive impairment after stroke: Clinical determinants and its associations with long-term stroke outcomes. Journal of the American Geriatrics Society, 50(4), 700-706.
  40. Rayner, L., Price, A., Evans, A., Valsraj, K., Higginson, I. J., & Hotopf, M. (2010). Antide- pressants for depression in physically ill people. Cochrane Database of Systematic Reviews. http://dx.doi.org/10.1002/14651858.CD007503.pub2 (Issue 3. Art. No.: CD007503). · DOI
  41. Reijnders, J. S. A.M., Ehrt, U., Weber, W. E. J., Aarslag, D., & Leentjens, A. F. G. (2008). A sys- tematic review of prevalence studies of depression in Parkinson's disease. Movement Disorders, 23(2), 183-189.
  42. Shaw, J. W., Johnson, J. A., & Coons, S. J. (2005). US valuation of the EQ-5D health states: Development and testing of the D1 valuation model. Medical Care, 43(3), 203-220.
  43. Stiegelis, H. E., Hagedoorn, M., Sanderman, R., Bennenbroek, F. T. C., Buunk, B. P., van den Bergh, A.C. M., et al. (2004). The impact of an informational self-management inter- vention on the association between control and illness uncertainty before and psy- chological distress after radiotherapy. Psycho-Oncology, 13(4), 248-259.
  44. Unützer, J., Schoenbaum, M., Druss, B. G., & Katon, W. J. (2006). Transforming mental health care at the interface with general medicine: Report for the President's com- mission. Psychiatric Services, 57(1). http://dx.doi.org/10.1176/appi.ps.57.1.37. van Tulder, M., Furlan, A., Bombardier, C., & Bouter, L. (2003). The editorial board of the Cochrane collaboration back review group. Spine, 28(12), 1290-1299. · DOI
  45. Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30(6), 473-483.
  46. Williams, C., & Whitfield, G. (2001). Written and computer-based self-help treatments for depression. British Medical Bulletin, 57(1), 133-144.
  47. Williams-Piehota, P., Pizarro, J., Schneider, T. R., Mowad, L., & Salovey, P. (2005). Matching health messages to monitor-blunter coping styles to motivate screening mammogra- phy. Health Psychology, 24(1), 58-67.

Cited by

Sorted by citations

Authors
Matcham, F., Rayner, L., Hutton, J., Monk, A., Steel, C., & Hotopf, M.
Affiliations
  • King's College London (GB)
  • South London and Maudsley NHS Foundation Trust (GB)
Corresponding author
Matcham, F.
ORCID
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2014-03
Volume
34
Issue
2
Pages
141-157
ISSN
0272-7358 (ISSN-L)
DOI
10.1016/j.cpr.2014.01.005
OpenAlex
W1988661281
Cited by
85
References
19
Citations by year
2026: 2 · 2025: 6 · 2024: 7 · 2023: 8 · 2022: 10 · 2021: 5 · 2020: 5 · 2019: 6 · 2018: 9 · 2017: 6 · 2016: 9 · 2015: 7 · 2014: 5
FWCI
1.09
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Psychology Review (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • CentAUR (University of Reading) (acceptedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
  • National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
  • King's College London
  • King's Health Partners Academic Health Science Centre
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
self-help intervention, depression, anxiety, psychological distress, physical illness, chronic physical illness, cognitive behavioral therapy, stress management
MeSH terms
Anxiety, Depression, Humans, Psychotherapy, Self Care, Stress, Psychological

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review