Literature Review Suggests Peer-Support Interventions Reduce Symptoms of Depression Better than Usual Care
BACKGROUND:
Antidepressant medications are an effective treatment for major depressive disorder, but studies suggest that additional services are needed to help patients cope with continued symptoms even while they receive evidence-based treatments. For example, peer-support services can be an adjunct to standard depression treatment. While cost and availability can be significant barriers to the use of professional mental health services, peer-support services that rely on voluntary efforts of non-professionals have the potential to be widely available at relatively low cost. However, these programs have been limited in their availability and integration with formal mental health treatment. Investigators in this study conducted a meta-analysis of published randomized clinical trials (RCTs) to determine the evidence base for peer-support services for depression. Specifically, investigators assessed whether peer-support interventions resulted in a greater reduction of depression symptoms compared to either usual care or psychotherapy (group cognitive behavioral therapy only).
FINDINGS:
- Seven RCTs (869 participants) comparing peer support vs. usual care for depression showed a significantly greater reduction in mean depression scores with peer support.
- Seven RCTs (301 participants) comparing a peer-support intervention to group cognitive behavioral therapy (CBT) showed no statistically significant difference between group CBT and peer interventions.
- These findings suggest that peer-support interventions have the potential to be effective components of depression care.
LIMITATIONS:
- Many of the studies included in this meta-analysis drew from sub-populations of individuals with depression (e.g., post-partum women, men with HIV). While this may improve the generalizability of findings to patients with depression who have comorbid general medical conditions, the findings may be less generalizable to patients with depression and no other co-occurring conditions.
- The small number of available studies limited the investigators’ ability to analyze in more detail specific factors that may influence the effectiveness of peer-support interventions.
AUTHOR/FUNDING INFORMATION:
This study was partly funded through HSR&D (IIR 08-325). Drs. Pfeiffer, Heisler, Piette, and Valenstein are part of HSR&D’s Center for Clinical Management Research in Ann Arbor, MI.
Pfeiffer P, Heisler M, Piette J, Rogers M, and Valenstein M. Efficacy of Peer Support Interventions for Depression: A Meta-Analysis. General Hospital Psychiatry 2011 Jan-Feb;33(1):29-36.
