Bibliotherapy as a Treatment for Depression in Primary Care
This study was designed to determine whether a physician-delivered bibliotherapy prescription would compare favorably with the prevailing usual care treatment for depression in primary care (that often involves medication) and potentially offer an alternative. Six family physicians were trained to write and deliver prescriptions for cognitive-behavioral bibliotherapy. Thirty-eight patients were randomly assigned to receive either usual care or a behavioral prescription to read the self-help book, Feeling Good (Burns, D. D. (1999). Feeling good: The new mood therapy. New York: HarperCollins). The treatment groups did not differ in terms of overall outcome variables. Patients in both treatment groups reported statistically significant decreases in depression symptoms, decreases in dysfunctional attitudes, and increases in quality of life. Although not statistically significant, the mean net medical expenses in the behavioral prescription group were substantially less. This study provided empirical evidence that a behavioral prescription for Feeling Good may be as effective as standard care, which commonly involves an antidepressant prescription.
KeywordsDepression Primary care Bibliotherapy Usual care
- Antonuccio, D. O., Burns, D. D., & Danton, W. G. (2002). Antidepressants: A triumph of marketing over science? Prevention and Treatment, 5. Available at: http://journals.apa.org/prevention/volume5/pre0050025c.html.
- Beck, A. T., Steer, R. A., Ball, R., Ciervo, C. A., & Kabat, M. (1997). Use of Beck Anxiety and Beck Depression Inventories for Primary Care with medical outpatients. Assessment, 4, 211–219.Google Scholar
- Beck, A. T., Steer, R. A., & Brown, G. K. (2000). Manual for the Beck Depression Inventory-Fast Screen for medical patients. San Antonio, TX: Psychological Corporation.Google Scholar
- Borkovec, T. D. (1990). Control groups and comparison groups in psychotherapy outcome research. National Institute on Drug Abuse: Research Monograph Series, Mono, 140, 50–65.Google Scholar
- Bryk, A. S., & Raudenbush, S. W. (1992). Hierarchical linear models: Applications and data analysis methods. Newbury Park, CA: Sage.Google Scholar
- Burns, D. D. (1999). Feeling good: The new mood therapy. New York: HarperCollins.Google Scholar
- Cuijpers, P., van Straten, A., Warmerdam, L., & Andersson, G. (2008). Psychological treatment of depression: A meta-analytic database of randomized studies. BMC Psychiatry, 8, 36. doi:10.1186/1471-244X-8-36.
- Cummings, N. A., Pallik, H., Dorken, M. S., & Henke, C. J. (2000). Medicaid, managed mental healthcare and medical cost offset. In J. L. Thomas & J. L. Cummings (Eds.), The value of psychological treatment (pp. 324–335). Pheonix, AZ: Zeig, Tucker and Company Inc.Google Scholar
- Dalfen, A. K., & Stewart, D. E. (2001). Who develops stable or fatal adverse drug reactions to selective serotonin reuptake inhibitors? Canadian Journal of Psychiatry, 46, 258–262.Google Scholar
- Dean, A. G., Dean, J. A., Coulimbier, D., Brendel, K. A., Smith, D. C., Burton, A. H., et al. (1995). A word processor database and statistics program for public health on IBM-compatible microcomputers (6th ed.). Atlanta, GA: Centers for Disease Control and Prevention.Google Scholar
- Dobson, K. S., Hollon, S. D., Dimidjian, S., Schmaling, K. B., Kohlenberg, R. J., Gallop, R. J., et al. (2008). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence in major depression. Journal of Consulting and Clinical Psychology, 76, 468–477.CrossRefPubMedGoogle Scholar
- Haaga, D. A., & Stiles, W. B. (2002). Randomized clinical trials in psychotherapy research: Methodology, design, and evaluation. In C. R. Snyder & R. E. Ingram (Eds.), Handbook of psychological change; Psychotherapy processes and practices for the 21st century (pp. 14–39). New York: Wiley.Google Scholar
- Hintze, J. (2008). PASS. Kaysville, UT: NCSS LLC.Google Scholar
- Hunsley, J. (2003). Cost-effectiveness and medical cost offset considerations in psychological service provision. Canadian Psychology, 44, 61–73.Google Scholar
- Mental Health Foundation Report: Exercise therapy? The treatment of mild and moderate depression in primary care. (2006). Retrieved on June 16, 2006 from http://www.psychminded.co.uk/news/news2005/april05/up_and_running.pdf.
- Moore, T. J. (2004). Drug safety research: Special report. Medical use of antidepressant drugs in children and adults: 1998–2001. Paper presented at the Feb. 2, 2004 FDA Hearing on the Use of Antidepressants in Children. Retrieved on March 2, 2004 from http://drugsafetyresearch.com/downloads/med_use_antidep.pdf.
- Smoller, J. W., Allison, M., Cochrane, B. B., Curb, J. D., Perlis, R. H., Robinson, J. G., et al. (2009). Antidepressant use and risk of incident cardiovascular morbidity and mortality among postmenopausal women in the Women’s Health Initiative study. Archives of Internal Medicine, 169, 2128–2139.CrossRefPubMedGoogle Scholar
- SPSS for Windows, Rel. 12.0. (1999). Chicago: SPSS Inc.Google Scholar
- SPSS Graduate Pack for Windows, Rel. 15.0. (2006). Chicago: SPSS Inc.Google Scholar
- Weissman, A. N., & Beck, A. T. (1978). Development and validation of the Dysfunctional Attitude Scale: A preliminary investigation. Paper presented at the Meeting of the American Educational Research Association, Toronto.Google Scholar