Non-directive Counselling and Cognitive Behaviour Therapy Have Short-Term Benefits Over Usual GP Care for Depression But Are Not More Cost-effective in the Long Term

Depression is accepted as a major health problem. The World Health Organization predicts that in the next 10 years, depression will become the major health problem in the world, ahead of physical medical problems such as heart attacks and strokes. Evidence based literature has consistently shown that pharmacotherapy and cognitive behaviour therapy are efficacious treatments of choice for the disorder. The effectiveness of non-directive counselling and the use of general practitioners in prescribing pharmacotherapy for depression is not well supported. In the randomised controlled trial described in these papers, both non-directive counselling and usual general practitioner care were as effective as cognitive behaviour therapy for the treatment of patients with depression or mixed depression and anxiety. While one can always find methodological weaknesses, it must be said that the studies are well conducted and thus the findings are a welcome addition to the literature. The conclusions of these two papers give practitioners of non-directive counselling and general practitioners more confidence in their treatment of depression in community clinics