Problem solving treatment and group psychoeducation for depression: multicentre randomised controlled trial

A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Abstract Objectives To determine the acceptability of two psychological interventions for depressed adults in the community and their effect on caseness, symptoms, and subjective function.Design A pragmatic multicentre randomised controlled trial, stratified by centre.Setting Nine urban and rural communities in Finland, Republic of Ireland, Norway, Spain, and the United Kingdom.Participants 452 participants aged 18 to 65, identified through a community survey with depressive or adjustment disorders according to the international classification of diseases, 10th revision or Diagnostic and Statistical Manual of Mental Disorders, fourth edition.Interventions Six individual sessions of problem solving treatment (n = 128), eight group sessions of the course on prevention of depression (n = 108), and controls (n = 189). Main outcome measures Completion rates for each intervention, diagnosis of depression, and depressive symptoms and subjective function.Results 63% of participants assigned to problem solving and 44% assigned to prevention of depression completed their intervention.The proportion of problem solving participants depressed at six months was 17% less than that for controls, giving a number needed to treat of 6; the mean difference in Beck depression inventory score was -2.63 (95% confidence interval -4.95 to -0.32), and there were significant improvements in SF-36 scores.For depression prevention, the difference in proportions of depressed participants was 14% (number needed to treat of 7); the mean difference in Beck depression inventory score was -1.50 (-4.16 to 1.17), and there were significant improvements in SF-36 scores.Such differences were not observed at 12 months.Neither specific diagnosis nor treatment with antidepressants affected outcome.Conclusions When offered to adults with depressive disorders in the community, problem solving treatment was more acceptable than the course on prevention of depression.Both interventions reduced caseness and improved subjective function.

It may state two separate claims as one.

A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Abstract Objectives To determine the acceptability of two psychological interventions for depressed adults in the community and their effect on caseness, symptoms, and subjective function.Design A pragmatic multicentre randomised controlled trial, stratified by centre.Setting Nine urban and rural communities in Finland, Republic of Ireland, Norway, Spain, and the United Kingdom.Participants 452 participants aged 18 to 65, identified through a community survey with depressive or adjustment disorders according to the international classification of diseases, 10th revision or Diagnostic and Statistical Manual of Mental Disorders, fourth edition.Interventions Six individual sessions of problem solving treatment (n = 128), eight group sessions of the course on prevention of depression (n = 108), and controls (n = 189). Main outcome measures Completion rates for each intervention, diagnosis of depression, and depressive symptoms and subjective function.Results 63% of participants assigned to problem solving and 44% assigned to prevention of depression completed their intervention.The proportion of problem solving participants depressed at six months was 17% less than that for controls, giving a number needed to treat of 6; the mean difference in Beck depression inventory score was -2.63 (95% confidence interval -4.95 to -0.32), and there were significant improvements in SF-36 scores.For depression prevention, the difference in proportions of depressed participants was 14% (number needed to treat of 7); the mean difference in Beck depression inventory score was -1.50 (-4.16 to 1.17), and there were significant improvements in SF-36 scores.Such differences were not observed at 12 months.Neither specific diagnosis nor treatment with antidepressants affected outcome.Conclusions When offered to adults with depressive disorders in the community, problem solving treatment was more acceptable than the course on prevention of depression.Both interventions reduced caseness and improved subjective function.

It may state two separate claims as one.

A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Abstract Objectives To determine the acceptability of two psychological interventions for depressed adults in the community and their effect on caseness, symptoms, and subjective function.Design A pragmatic multicentre randomised controlled trial, stratified by centre.Setting Nine urban and rural communities in Finland, Republic of Ireland, Norway, Spain, and the United Kingdom.Participants 452 participants aged 18 to 65, identified through a community survey with depressive or adjustment disorders according to the international classification of diseases, 10th revision or Diagnostic and Statistical Manual of Mental Disorders, fourth edition.Interventions Six individual sessions of problem solving treatment (n = 128), eight group sessions of the course on prevention of depression (n = 108), and controls (n = 189). Main outcome measures Completion rates for each intervention, diagnosis of depression, and depressive symptoms and subjective function.Results 63% of participants assigned to problem solving and 44% assigned to prevention of depression completed their intervention.The proportion of problem solving participants depressed at six months was 17% less than that for controls, giving a number needed to treat of 6; the mean difference in Beck depression inventory score was -2.63 (95% confidence interval -4.95 to -0.32), and there were significant improvements in SF-36 scores.For depression prevention, the difference in proportions of depressed participants was 14% (number needed to treat of 7); the mean difference in Beck depression inventory score was -1.50 (-4.16 to 1.17), and there were significant improvements in SF-36 scores.Such differences were not observed at 12 months.Neither specific diagnosis nor treatment with antidepressants affected outcome.Conclusions When offered to adults with depressive disorders in the community, problem solving treatment was more acceptable than the course on prevention of depression.Both interventions reduced caseness and improved subjective function.

It may state two separate claims as one.

A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Conclusions

The quote only partly states this claim.

A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Characteristics of the sample Overall, 452 people were identified as cases through the survey phase of the project of the outcomes of depression international network.Those who responded to the survey were more likely to be female and older than non-responders: the sex difference was significant at three sites.23 Randomisation and assessment were correctly undertaken for 425 people-26 people recruited in Dublin were excluded post hoc from the analysis, after discovery of a breach in protocol by a former member of the Irish research team, and one participant with a psychotic condition was excluded from the Norwegian sample (figure).Table 2 shows the baseline socioeconomic profiles of participants in each of the three arms.Diagnoses for 412 participants were based on the international classification of diseases, 10th revision: 238 (58%) single depressive episodes and 82 (20%) recurrent depressive episodes, 58 (14%) dysthymia, 21 (5%) adjustment disorder, and 13 (3%) others.Diagnoses for 418 participants were based on the DSM-IV: 216 (52%) single major depressive disorders and 81 (19%) recurrent major depressive disorders, 67 (16%) dysthymia, 18 (4%) adjustment disorders, and 36 (9%) others.Of 394 participants with available data, 102 (26%) reported currently taking antidepressants.There were no significant differences in diagnosis or antidepressant receipt between the study sites or the intervention arms.Table 3 gives numbers of baseline and follow up interviews completed for participants, at each centre.Differential recruitment between centres reflected differences in the prevalence of depressive disorders in the populations surveyed during the first phase of the outcomes of depression international network.23 We provided 11 courses in depression prevention-three in Ireland, seven in Norway, and one in the United Kingdom. Overall, 317 (74%) participants took part in follow up interviews at six months and 301 (71%) at 12 months (figure).There were significant differences between the nine centres in the proportions of participants reinterviewed at six months ( 2 = 17.52, df = 8, P = 0.025) and 12 months ( 2 = 21.47,df = 8, P = 0.006).No significant differences were found in follow up rates between the three trial groups at either six or 12 months.From a logistic regression analysis for the whole sample the probability of providing a follow up interview decreased with increasing baseline score on the Beck depression inventory: at six months = -0.017(0.013 SE); P = 0.203 and at 12 months = -0.025(0.013 SE), P = 0.047.

Probably not a substantial claim. The paper’s conclusions may not depend on it.

The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.

§ General practice > Acceptability of the interventions

It may state two separate claims as one.

A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Conclusions

Probably not a substantial claim. The authors may not put it forward as true. The quote only partly states this claim.

A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Characteristics of the sample Overall, 452 people were identified as cases through the survey phase of the project of the outcomes of depression international network.Those who responded to the survey were more likely to be female and older than non-responders: the sex difference was significant at three sites.23 Randomisation and assessment were correctly undertaken for 425 people-26 people recruited in Dublin were excluded post hoc from the analysis, after discovery of a breach in protocol by a former member of the Irish research team, and one participant with a psychotic condition was excluded from the Norwegian sample (figure).Table 2 shows the baseline socioeconomic profiles of participants in each of the three arms.Diagnoses for 412 participants were based on the international classification of diseases, 10th revision: 238 (58%) single depressive episodes and 82 (20%) recurrent depressive episodes, 58 (14%) dysthymia, 21 (5%) adjustment disorder, and 13 (3%) others.Diagnoses for 418 participants were based on the DSM-IV: 216 (52%) single major depressive disorders and 81 (19%) recurrent major depressive disorders, 67 (16%) dysthymia, 18 (4%) adjustment disorders, and 36 (9%) others.Of 394 participants with available data, 102 (26%) reported currently taking antidepressants.There were no significant differences in diagnosis or antidepressant receipt between the study sites or the intervention arms.Table 3 gives numbers of baseline and follow up interviews completed for participants, at each centre.Differential recruitment between centres reflected differences in the prevalence of depressive disorders in the populations surveyed during the first phase of the outcomes of depression international network.23 We provided 11 courses in depression prevention-three in Ireland, seven in Norway, and one in the United Kingdom. Overall, 317 (74%) participants took part in follow up interviews at six months and 301 (71%) at 12 months (figure).There were significant differences between the nine centres in the proportions of participants reinterviewed at six months ( 2 = 17.52, df = 8, P = 0.025) and 12 months ( 2 = 21.47,df = 8, P = 0.006).No significant differences were found in follow up rates between the three trial groups at either six or 12 months.From a logistic regression analysis for the whole sample the probability of providing a follow up interview decreased with increasing baseline score on the Beck depression inventory: at six months = -0.017(0.013 SE); P = 0.203 and at 12 months = -0.025(0.013 SE), P = 0.047.

Probably not a substantial claim. The paper’s conclusions may not depend on it.

§ General practice > Characteristics of the sample Overall, 452 people were identified as cases through the survey phase of the project of the outcomes of depression international network.Those who responded to the survey were more likely to be female and older than non-responders: the sex difference was significant at three sites.23 Randomisation and assessment were correctly undertaken for 425 people-26 people recruited in Dublin were excluded post hoc from the analysis, after discovery of a breach in protocol by a former member of the Irish research team, and one participant with a psychotic condition was excluded from the Norwegian sample (figure).Table 2 shows the baseline socioeconomic profiles of participants in each of the three arms.Diagnoses for 412 participants were based on the international classification of diseases, 10th revision: 238 (58%) single depressive episodes and 82 (20%) recurrent depressive episodes, 58 (14%) dysthymia, 21 (5%) adjustment disorder, and 13 (3%) others.Diagnoses for 418 participants were based on the DSM-IV: 216 (52%) single major depressive disorders and 81 (19%) recurrent major depressive disorders, 67 (16%) dysthymia, 18 (4%) adjustment disorders, and 36 (9%) others.Of 394 participants with available data, 102 (26%) reported currently taking antidepressants.There were no significant differences in diagnosis or antidepressant receipt between the study sites or the intervention arms.Table 3 gives numbers of baseline and follow up interviews completed for participants, at each centre.Differential recruitment between centres reflected differences in the prevalence of depressive disorders in the populations surveyed during the first phase of the outcomes of depression international network.23 We provided 11 courses in depression prevention-three in Ireland, seven in Norway, and one in the United Kingdom. Overall, 317 (74%) participants took part in follow up interviews at six months and 301 (71%) at 12 months (figure).There were significant differences between the nine centres in the proportions of participants reinterviewed at six months ( 2 = 17.52, df = 8, P = 0.025) and 12 months ( 2 = 21.47,df = 8, P = 0.006).No significant differences were found in follow up rates between the three trial groups at either six or 12 months.From a logistic regression analysis for the whole sample the probability of providing a follow up interview decreased with increasing baseline score on the Beck depression inventory: at six months = -0.017(0.013 SE); P = 0.203 and at 12 months = -0.025(0.013 SE), P = 0.047.

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Characteristics of the sample Overall, 452 people were identified as cases through the survey phase of the project of the outcomes of depression international network.Those who responded to the survey were more likely to be female and older than non-responders: the sex difference was significant at three sites.23 Randomisation and assessment were correctly undertaken for 425 people-26 people recruited in Dublin were excluded post hoc from the analysis, after discovery of a breach in protocol by a former member of the Irish research team, and one participant with a psychotic condition was excluded from the Norwegian sample (figure).Table 2 shows the baseline socioeconomic profiles of participants in each of the three arms.Diagnoses for 412 participants were based on the international classification of diseases, 10th revision: 238 (58%) single depressive episodes and 82 (20%) recurrent depressive episodes, 58 (14%) dysthymia, 21 (5%) adjustment disorder, and 13 (3%) others.Diagnoses for 418 participants were based on the DSM-IV: 216 (52%) single major depressive disorders and 81 (19%) recurrent major depressive disorders, 67 (16%) dysthymia, 18 (4%) adjustment disorders, and 36 (9%) others.Of 394 participants with available data, 102 (26%) reported currently taking antidepressants.There were no significant differences in diagnosis or antidepressant receipt between the study sites or the intervention arms.Table 3 gives numbers of baseline and follow up interviews completed for participants, at each centre.Differential recruitment between centres reflected differences in the prevalence of depressive disorders in the populations surveyed during the first phase of the outcomes of depression international network.23 We provided 11 courses in depression prevention-three in Ireland, seven in Norway, and one in the United Kingdom. Overall, 317 (74%) participants took part in follow up interviews at six months and 301 (71%) at 12 months (figure).There were significant differences between the nine centres in the proportions of participants reinterviewed at six months ( 2 = 17.52, df = 8, P = 0.025) and 12 months ( 2 = 21.47,df = 8, P = 0.006).No significant differences were found in follow up rates between the three trial groups at either six or 12 months.From a logistic regression analysis for the whole sample the probability of providing a follow up interview decreased with increasing baseline score on the Beck depression inventory: at six months = -0.017(0.013 SE); P = 0.203 and at 12 months = -0.025(0.013 SE), P = 0.047.

Probably not a substantial claim. The paper’s conclusions may not depend on it.

A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Characteristics of the sample Overall, 452 people were identified as cases through the survey phase of the project of the outcomes of depression international network.Those who responded to the survey were more likely to be female and older than non-responders: the sex difference was significant at three sites.23 Randomisation and assessment were correctly undertaken for 425 people-26 people recruited in Dublin were excluded post hoc from the analysis, after discovery of a breach in protocol by a former member of the Irish research team, and one participant with a psychotic condition was excluded from the Norwegian sample (figure).Table 2 shows the baseline socioeconomic profiles of participants in each of the three arms.Diagnoses for 412 participants were based on the international classification of diseases, 10th revision: 238 (58%) single depressive episodes and 82 (20%) recurrent depressive episodes, 58 (14%) dysthymia, 21 (5%) adjustment disorder, and 13 (3%) others.Diagnoses for 418 participants were based on the DSM-IV: 216 (52%) single major depressive disorders and 81 (19%) recurrent major depressive disorders, 67 (16%) dysthymia, 18 (4%) adjustment disorders, and 36 (9%) others.Of 394 participants with available data, 102 (26%) reported currently taking antidepressants.There were no significant differences in diagnosis or antidepressant receipt between the study sites or the intervention arms.Table 3 gives numbers of baseline and follow up interviews completed for participants, at each centre.Differential recruitment between centres reflected differences in the prevalence of depressive disorders in the populations surveyed during the first phase of the outcomes of depression international network.23 We provided 11 courses in depression prevention-three in Ireland, seven in Norway, and one in the United Kingdom. Overall, 317 (74%) participants took part in follow up interviews at six months and 301 (71%) at 12 months (figure).There were significant differences between the nine centres in the proportions of participants reinterviewed at six months ( 2 = 17.52, df = 8, P = 0.025) and 12 months ( 2 = 21.47,df = 8, P = 0.006).No significant differences were found in follow up rates between the three trial groups at either six or 12 months.From a logistic regression analysis for the whole sample the probability of providing a follow up interview decreased with increasing baseline score on the Beck depression inventory: at six months = -0.017(0.013 SE); P = 0.203 and at 12 months = -0.025(0.013 SE), P = 0.047.

It may state two separate claims as one.

A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Abstract Objectives To determine the acceptability of two psychological interventions for depressed adults in the community and their effect on caseness, symptoms, and subjective function.Design A pragmatic multicentre randomised controlled trial, stratified by centre.Setting Nine urban and rural communities in Finland, Republic of Ireland, Norway, Spain, and the United Kingdom.Participants 452 participants aged 18 to 65, identified through a community survey with depressive or adjustment disorders according to the international classification of diseases, 10th revision or Diagnostic and Statistical Manual of Mental Disorders, fourth edition.Interventions Six individual sessions of problem solving treatment (n = 128), eight group sessions of the course on prevention of depression (n = 108), and controls (n = 189). Main outcome measures Completion rates for each intervention, diagnosis of depression, and depressive symptoms and subjective function.Results 63% of participants assigned to problem solving and 44% assigned to prevention of depression completed their intervention.The proportion of problem solving participants depressed at six months was 17% less than that for controls, giving a number needed to treat of 6; the mean difference in Beck depression inventory score was -2.63 (95% confidence interval -4.95 to -0.32), and there were significant improvements in SF-36 scores.For depression prevention, the difference in proportions of depressed participants was 14% (number needed to treat of 7); the mean difference in Beck depression inventory score was -1.50 (-4.16 to 1.17), and there were significant improvements in SF-36 scores.Such differences were not observed at 12 months.Neither specific diagnosis nor treatment with antidepressants affected outcome.Conclusions When offered to adults with depressive disorders in the community, problem solving treatment was more acceptable than the course on prevention of depression.Both interventions reduced caseness and improved subjective function.

It may state two separate claims as one.

None of the sources cited for this claim have been checked yet.

§ General practice > Introduction

Probably not a substantial claim. The paper’s conclusions may not depend on it.

None of the sources cited for this claim have been checked yet.

§ General practice > Introduction

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.

§ General practice > Characteristics of the sample Overall, 452 people were identified as cases through the survey phase of the project of the outcomes of depression international network.Those who responded to the survey were more likely to be female and older than non-responders: the sex difference was significant at three sites.23 Randomisation and assessment were correctly undertaken for 425 people-26 people recruited in Dublin were excluded post hoc from the analysis, after discovery of a breach in protocol by a former member of the Irish research team, and one participant with a psychotic condition was excluded from the Norwegian sample (figure).Table 2 shows the baseline socioeconomic profiles of participants in each of the three arms.Diagnoses for 412 participants were based on the international classification of diseases, 10th revision: 238 (58%) single depressive episodes and 82 (20%) recurrent depressive episodes, 58 (14%) dysthymia, 21 (5%) adjustment disorder, and 13 (3%) others.Diagnoses for 418 participants were based on the DSM-IV: 216 (52%) single major depressive disorders and 81 (19%) recurrent major depressive disorders, 67 (16%) dysthymia, 18 (4%) adjustment disorders, and 36 (9%) others.Of 394 participants with available data, 102 (26%) reported currently taking antidepressants.There were no significant differences in diagnosis or antidepressant receipt between the study sites or the intervention arms.Table 3 gives numbers of baseline and follow up interviews completed for participants, at each centre.Differential recruitment between centres reflected differences in the prevalence of depressive disorders in the populations surveyed during the first phase of the outcomes of depression international network.23 We provided 11 courses in depression prevention-three in Ireland, seven in Norway, and one in the United Kingdom. Overall, 317 (74%) participants took part in follow up interviews at six months and 301 (71%) at 12 months (figure).There were significant differences between the nine centres in the proportions of participants reinterviewed at six months ( 2 = 17.52, df = 8, P = 0.025) and 12 months ( 2 = 21.47,df = 8, P = 0.006).No significant differences were found in follow up rates between the three trial groups at either six or 12 months.From a logistic regression analysis for the whole sample the probability of providing a follow up interview decreased with increasing baseline score on the Beck depression inventory: at six months = -0.017(0.013 SE); P = 0.203 and at 12 months = -0.025(0.013 SE), P = 0.047.

It may state two separate claims as one.

§ General practice > Introduction

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

§ General practice > Introduction

Probably not a substantial claim. The paper’s conclusions may not depend on it.

What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.

§ General practice > Statistical methods The number of participants recruited fell far short of those planned in the original sample size calculations, which were optimistically intended to test the effectiveness of the interventions at each centre separately.8 Here, however, we are concerned with estimation and testing the therapy effects for the centres combined.Revised sample size requirements were calculated on the basis of the outcomes of the Beck depression inventory and schedule for clinical assessment in neuropsychiatry, using a two sided 5% significance level, and assuming a ratio of 1:1:2 for problem solving, depression prevention, and controls.Given the uncertainty of outcome from a study based outside healthcare settings, we made no assumptions concerning the difference in efficacy of problem solving and prevention of depression.Our data have limited power to differentiate the effects of the two forms of therapy.Our trial contained around 200 patients receiving treatment and around 200 controls.These sample sizes are sufficient to have about 85% power to detect a difference between treatment and control groups of 2.5 (8 SD) points on the Beck depression inventory with Student's t test.For the schedule for clinical assessment in neuropsychiatry, with the outcome being "no longer a case," the trial has about 85% power to detect a 15% difference (35% recovery in controls versus 50% for therapy, odds ratio = 0.54) in outcome between interventions and control with a Pearson 2 test.The corresponding power for comparing individual therapies with the controls (i.e. using 100 patients per group) is about 60%. The design of the trial is complex, involving nine treatment centres, only one of which used both interventions.It is essential, therefore, in estimating and testing treatment effects that the analysis involves stratification by centre to ensure that each intervention group is being compared with its own control.Quantitative outcomes (scores on the Beck depression inventory and the SF-36 subscales) were analysed with an analysis of covariance.Outcomes at six months and 12 months were analysed separately.Relevant baseline scores, age, and treatment with antidepressants were used as covariates, and treatment group, centre, and diagnostic group were treated as qualitative factors.Centre effects were treated as either random or fixed.Qualitative outcomes (diagnosis of depression) were analysed similarly, but here using logistic regression instead of an analysis of covariance.All analyses of treatment effects were carried out with reg, xtreg (random effects models), logit, and xtlogit (random effects models) from STATA (release 6). Not all patients provided follow up information.All analyses were carried out by intention to treat but with alternative approaches to dealing with the effects of drop-outs.21 Firstly, analysis of available data (complete case analysis) assumed that data are missing completely at random.22 It was clear, however, that factors such as treatment allocation and the acceptability of the treatment offered influenced drop-out rates.The second approach therefore assumed that data were missing at random, involving calculation of adjustment weights to compensate for missing values.22 Probability of providing a follow up interview was predicted with baseline Beck depression inventory, treatment group, acceptability of treatment, and treatment centre in an unweighted logistic regression (using logit).The reciprocal of this probability was then used as an adjustment (probability) weight using logit in a weighted logistic regression to estimate the treatment effects in the main analyses.

Probably not a substantial claim.

A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Additional information

It may state two separate claims as one.

§ General practice > Characteristics of the sample Overall, 452 people were identified as cases through the survey phase of the project of the outcomes of depression international network.Those who responded to the survey were more likely to be female and older than non-responders: the sex difference was significant at three sites.23 Randomisation and assessment were correctly undertaken for 425 people-26 people recruited in Dublin were excluded post hoc from the analysis, after discovery of a breach in protocol by a former member of the Irish research team, and one participant with a psychotic condition was excluded from the Norwegian sample (figure).Table 2 shows the baseline socioeconomic profiles of participants in each of the three arms.Diagnoses for 412 participants were based on the international classification of diseases, 10th revision: 238 (58%) single depressive episodes and 82 (20%) recurrent depressive episodes, 58 (14%) dysthymia, 21 (5%) adjustment disorder, and 13 (3%) others.Diagnoses for 418 participants were based on the DSM-IV: 216 (52%) single major depressive disorders and 81 (19%) recurrent major depressive disorders, 67 (16%) dysthymia, 18 (4%) adjustment disorders, and 36 (9%) others.Of 394 participants with available data, 102 (26%) reported currently taking antidepressants.There were no significant differences in diagnosis or antidepressant receipt between the study sites or the intervention arms.Table 3 gives numbers of baseline and follow up interviews completed for participants, at each centre.Differential recruitment between centres reflected differences in the prevalence of depressive disorders in the populations surveyed during the first phase of the outcomes of depression international network.23 We provided 11 courses in depression prevention-three in Ireland, seven in Norway, and one in the United Kingdom. Overall, 317 (74%) participants took part in follow up interviews at six months and 301 (71%) at 12 months (figure).There were significant differences between the nine centres in the proportions of participants reinterviewed at six months ( 2 = 17.52, df = 8, P = 0.025) and 12 months ( 2 = 21.47,df = 8, P = 0.006).No significant differences were found in follow up rates between the three trial groups at either six or 12 months.From a logistic regression analysis for the whole sample the probability of providing a follow up interview decreased with increasing baseline score on the Beck depression inventory: at six months = -0.017(0.013 SE); P = 0.203 and at 12 months = -0.025(0.013 SE), P = 0.047.

Probably not a substantial claim. The paper’s conclusions may not depend on it.

What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.

§ General practice > Study sites and populations

Probably not a substantial claim. The paper’s conclusions may not depend on it.

What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.

§ General practice > Statistical methods The number of participants recruited fell far short of those planned in the original sample size calculations, which were optimistically intended to test the effectiveness of the interventions at each centre separately.8 Here, however, we are concerned with estimation and testing the therapy effects for the centres combined.Revised sample size requirements were calculated on the basis of the outcomes of the Beck depression inventory and schedule for clinical assessment in neuropsychiatry, using a two sided 5% significance level, and assuming a ratio of 1:1:2 for problem solving, depression prevention, and controls.Given the uncertainty of outcome from a study based outside healthcare settings, we made no assumptions concerning the difference in efficacy of problem solving and prevention of depression.Our data have limited power to differentiate the effects of the two forms of therapy.Our trial contained around 200 patients receiving treatment and around 200 controls.These sample sizes are sufficient to have about 85% power to detect a difference between treatment and control groups of 2.5 (8 SD) points on the Beck depression inventory with Student's t test.For the schedule for clinical assessment in neuropsychiatry, with the outcome being "no longer a case," the trial has about 85% power to detect a 15% difference (35% recovery in controls versus 50% for therapy, odds ratio = 0.54) in outcome between interventions and control with a Pearson 2 test.The corresponding power for comparing individual therapies with the controls (i.e. using 100 patients per group) is about 60%. The design of the trial is complex, involving nine treatment centres, only one of which used both interventions.It is essential, therefore, in estimating and testing treatment effects that the analysis involves stratification by centre to ensure that each intervention group is being compared with its own control.Quantitative outcomes (scores on the Beck depression inventory and the SF-36 subscales) were analysed with an analysis of covariance.Outcomes at six months and 12 months were analysed separately.Relevant baseline scores, age, and treatment with antidepressants were used as covariates, and treatment group, centre, and diagnostic group were treated as qualitative factors.Centre effects were treated as either random or fixed.Qualitative outcomes (diagnosis of depression) were analysed similarly, but here using logistic regression instead of an analysis of covariance.All analyses of treatment effects were carried out with reg, xtreg (random effects models), logit, and xtlogit (random effects models) from STATA (release 6). Not all patients provided follow up information.All analyses were carried out by intention to treat but with alternative approaches to dealing with the effects of drop-outs.21 Firstly, analysis of available data (complete case analysis) assumed that data are missing completely at random.22 It was clear, however, that factors such as treatment allocation and the acceptability of the treatment offered influenced drop-out rates.The second approach therefore assumed that data were missing at random, involving calculation of adjustment weights to compensate for missing values.22 Probability of providing a follow up interview was predicted with baseline Beck depression inventory, treatment group, acceptability of treatment, and treatment centre in an unweighted logistic regression (using logit).The reciprocal of this probability was then used as an adjustment (probability) weight using logit in a weighted logistic regression to estimate the treatment effects in the main analyses.

Probably not a substantial claim. It may state two separate claims as one.

§ General practice > Study sites and populations

Probably not a substantial claim. The paper’s conclusions may not depend on it.

What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.

§ General practice > Study design

Probably not a substantial claim.

What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.

§ General practice > Characteristics of the sample Overall, 452 people were identified as cases through the survey phase of the project of the outcomes of depression international network.Those who responded to the survey were more likely to be female and older than non-responders: the sex difference was significant at three sites.23 Randomisation and assessment were correctly undertaken for 425 people-26 people recruited in Dublin were excluded post hoc from the analysis, after discovery of a breach in protocol by a former member of the Irish research team, and one participant with a psychotic condition was excluded from the Norwegian sample (figure).Table 2 shows the baseline socioeconomic profiles of participants in each of the three arms.Diagnoses for 412 participants were based on the international classification of diseases, 10th revision: 238 (58%) single depressive episodes and 82 (20%) recurrent depressive episodes, 58 (14%) dysthymia, 21 (5%) adjustment disorder, and 13 (3%) others.Diagnoses for 418 participants were based on the DSM-IV: 216 (52%) single major depressive disorders and 81 (19%) recurrent major depressive disorders, 67 (16%) dysthymia, 18 (4%) adjustment disorders, and 36 (9%) others.Of 394 participants with available data, 102 (26%) reported currently taking antidepressants.There were no significant differences in diagnosis or antidepressant receipt between the study sites or the intervention arms.Table 3 gives numbers of baseline and follow up interviews completed for participants, at each centre.Differential recruitment between centres reflected differences in the prevalence of depressive disorders in the populations surveyed during the first phase of the outcomes of depression international network.23 We provided 11 courses in depression prevention-three in Ireland, seven in Norway, and one in the United Kingdom. Overall, 317 (74%) participants took part in follow up interviews at six months and 301 (71%) at 12 months (figure).There were significant differences between the nine centres in the proportions of participants reinterviewed at six months ( 2 = 17.52, df = 8, P = 0.025) and 12 months ( 2 = 21.47,df = 8, P = 0.006).No significant differences were found in follow up rates between the three trial groups at either six or 12 months.From a logistic regression analysis for the whole sample the probability of providing a follow up interview decreased with increasing baseline score on the Beck depression inventory: at six months = -0.017(0.013 SE); P = 0.203 and at 12 months = -0.025(0.013 SE), P = 0.047.

It may state two separate claims as one.

What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.

§ General practice > Limitations

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Implications

It may state two separate claims as one.

What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.

§ General practice > Statistical methods The number of participants recruited fell far short of those planned in the original sample size calculations, which were optimistically intended to test the effectiveness of the interventions at each centre separately.8 Here, however, we are concerned with estimation and testing the therapy effects for the centres combined.Revised sample size requirements were calculated on the basis of the outcomes of the Beck depression inventory and schedule for clinical assessment in neuropsychiatry, using a two sided 5% significance level, and assuming a ratio of 1:1:2 for problem solving, depression prevention, and controls.Given the uncertainty of outcome from a study based outside healthcare settings, we made no assumptions concerning the difference in efficacy of problem solving and prevention of depression.Our data have limited power to differentiate the effects of the two forms of therapy.Our trial contained around 200 patients receiving treatment and around 200 controls.These sample sizes are sufficient to have about 85% power to detect a difference between treatment and control groups of 2.5 (8 SD) points on the Beck depression inventory with Student's t test.For the schedule for clinical assessment in neuropsychiatry, with the outcome being "no longer a case," the trial has about 85% power to detect a 15% difference (35% recovery in controls versus 50% for therapy, odds ratio = 0.54) in outcome between interventions and control with a Pearson 2 test.The corresponding power for comparing individual therapies with the controls (i.e. using 100 patients per group) is about 60%. The design of the trial is complex, involving nine treatment centres, only one of which used both interventions.It is essential, therefore, in estimating and testing treatment effects that the analysis involves stratification by centre to ensure that each intervention group is being compared with its own control.Quantitative outcomes (scores on the Beck depression inventory and the SF-36 subscales) were analysed with an analysis of covariance.Outcomes at six months and 12 months were analysed separately.Relevant baseline scores, age, and treatment with antidepressants were used as covariates, and treatment group, centre, and diagnostic group were treated as qualitative factors.Centre effects were treated as either random or fixed.Qualitative outcomes (diagnosis of depression) were analysed similarly, but here using logistic regression instead of an analysis of covariance.All analyses of treatment effects were carried out with reg, xtreg (random effects models), logit, and xtlogit (random effects models) from STATA (release 6). Not all patients provided follow up information.All analyses were carried out by intention to treat but with alternative approaches to dealing with the effects of drop-outs.21 Firstly, analysis of available data (complete case analysis) assumed that data are missing completely at random.22 It was clear, however, that factors such as treatment allocation and the acceptability of the treatment offered influenced drop-out rates.The second approach therefore assumed that data were missing at random, involving calculation of adjustment weights to compensate for missing values.22 Probability of providing a follow up interview was predicted with baseline Beck depression inventory, treatment group, acceptability of treatment, and treatment centre in an unweighted logistic regression (using logit).The reciprocal of this probability was then used as an adjustment (probability) weight using logit in a weighted logistic regression to estimate the treatment effects in the main analyses.

Probably not a substantial claim.

What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.

§ General practice > Statistical methods The number of participants recruited fell far short of those planned in the original sample size calculations, which were optimistically intended to test the effectiveness of the interventions at each centre separately.8 Here, however, we are concerned with estimation and testing the therapy effects for the centres combined.Revised sample size requirements were calculated on the basis of the outcomes of the Beck depression inventory and schedule for clinical assessment in neuropsychiatry, using a two sided 5% significance level, and assuming a ratio of 1:1:2 for problem solving, depression prevention, and controls.Given the uncertainty of outcome from a study based outside healthcare settings, we made no assumptions concerning the difference in efficacy of problem solving and prevention of depression.Our data have limited power to differentiate the effects of the two forms of therapy.Our trial contained around 200 patients receiving treatment and around 200 controls.These sample sizes are sufficient to have about 85% power to detect a difference between treatment and control groups of 2.5 (8 SD) points on the Beck depression inventory with Student's t test.For the schedule for clinical assessment in neuropsychiatry, with the outcome being "no longer a case," the trial has about 85% power to detect a 15% difference (35% recovery in controls versus 50% for therapy, odds ratio = 0.54) in outcome between interventions and control with a Pearson 2 test.The corresponding power for comparing individual therapies with the controls (i.e. using 100 patients per group) is about 60%. The design of the trial is complex, involving nine treatment centres, only one of which used both interventions.It is essential, therefore, in estimating and testing treatment effects that the analysis involves stratification by centre to ensure that each intervention group is being compared with its own control.Quantitative outcomes (scores on the Beck depression inventory and the SF-36 subscales) were analysed with an analysis of covariance.Outcomes at six months and 12 months were analysed separately.Relevant baseline scores, age, and treatment with antidepressants were used as covariates, and treatment group, centre, and diagnostic group were treated as qualitative factors.Centre effects were treated as either random or fixed.Qualitative outcomes (diagnosis of depression) were analysed similarly, but here using logistic regression instead of an analysis of covariance.All analyses of treatment effects were carried out with reg, xtreg (random effects models), logit, and xtlogit (random effects models) from STATA (release 6). Not all patients provided follow up information.All analyses were carried out by intention to treat but with alternative approaches to dealing with the effects of drop-outs.21 Firstly, analysis of available data (complete case analysis) assumed that data are missing completely at random.22 It was clear, however, that factors such as treatment allocation and the acceptability of the treatment offered influenced drop-out rates.The second approach therefore assumed that data were missing at random, involving calculation of adjustment weights to compensate for missing values.22 Probability of providing a follow up interview was predicted with baseline Beck depression inventory, treatment group, acceptability of treatment, and treatment centre in an unweighted logistic regression (using logit).The reciprocal of this probability was then used as an adjustment (probability) weight using logit in a weighted logistic regression to estimate the treatment effects in the main analyses.

It may state two separate claims as one.

A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Conclusions

It may state two separate claims as one.

What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.

§ General practice > Study design

Probably not a substantial claim.

What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.

§ General practice > Study design

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.

§ General practice > Statistical methods The number of participants recruited fell far short of those planned in the original sample size calculations, which were optimistically intended to test the effectiveness of the interventions at each centre separately.8 Here, however, we are concerned with estimation and testing the therapy effects for the centres combined.Revised sample size requirements were calculated on the basis of the outcomes of the Beck depression inventory and schedule for clinical assessment in neuropsychiatry, using a two sided 5% significance level, and assuming a ratio of 1:1:2 for problem solving, depression prevention, and controls.Given the uncertainty of outcome from a study based outside healthcare settings, we made no assumptions concerning the difference in efficacy of problem solving and prevention of depression.Our data have limited power to differentiate the effects of the two forms of therapy.Our trial contained around 200 patients receiving treatment and around 200 controls.These sample sizes are sufficient to have about 85% power to detect a difference between treatment and control groups of 2.5 (8 SD) points on the Beck depression inventory with Student's t test.For the schedule for clinical assessment in neuropsychiatry, with the outcome being "no longer a case," the trial has about 85% power to detect a 15% difference (35% recovery in controls versus 50% for therapy, odds ratio = 0.54) in outcome between interventions and control with a Pearson 2 test.The corresponding power for comparing individual therapies with the controls (i.e. using 100 patients per group) is about 60%. The design of the trial is complex, involving nine treatment centres, only one of which used both interventions.It is essential, therefore, in estimating and testing treatment effects that the analysis involves stratification by centre to ensure that each intervention group is being compared with its own control.Quantitative outcomes (scores on the Beck depression inventory and the SF-36 subscales) were analysed with an analysis of covariance.Outcomes at six months and 12 months were analysed separately.Relevant baseline scores, age, and treatment with antidepressants were used as covariates, and treatment group, centre, and diagnostic group were treated as qualitative factors.Centre effects were treated as either random or fixed.Qualitative outcomes (diagnosis of depression) were analysed similarly, but here using logistic regression instead of an analysis of covariance.All analyses of treatment effects were carried out with reg, xtreg (random effects models), logit, and xtlogit (random effects models) from STATA (release 6). Not all patients provided follow up information.All analyses were carried out by intention to treat but with alternative approaches to dealing with the effects of drop-outs.21 Firstly, analysis of available data (complete case analysis) assumed that data are missing completely at random.22 It was clear, however, that factors such as treatment allocation and the acceptability of the treatment offered influenced drop-out rates.The second approach therefore assumed that data were missing at random, involving calculation of adjustment weights to compensate for missing values.22 Probability of providing a follow up interview was predicted with baseline Beck depression inventory, treatment group, acceptability of treatment, and treatment centre in an unweighted logistic regression (using logit).The reciprocal of this probability was then used as an adjustment (probability) weight using logit in a weighted logistic regression to estimate the treatment effects in the main analyses.

Probably not a substantial claim.

A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.

§ General practice > Conclusions

It may state two separate claims as one.