Table 1.

Study Characteristics for Problem-Solving Therapy as Intervention for Treating Depression and/or Anxiety Among Primary Care Patients (n = 11)

AuthorSample*DemographicsControlProvider and PCP's role in PST (if applicable)PST/PST-PC DosageDiagnostic or Symptom Severity CriteriaDepression and/or Outcome Measures
Barrett et al. (2001)T = 80
C1 = 80
C2 = 81§
44.1 year old (SD NR),MED
Placebo
Ph.D-level psychologists. PCP no involvement6 PST-PC sessions, lasting about 1 hour for the first visit and 30 minutes for subsequent visits.DSM-III-R, HDRS, PRIME-MDHSCL-D-20
HDRS
36.1% male,
90% white.
Chibanda et al. (2014)T = 30
C = 28
24.5 years old (SD = 4.9)MEDTrained Peer Counselor. PCP no involvement12 sessions (60 mins per session) group PST session which were modeled after a 7-step management plan for depression published earlier (Abbas et al., 1994)DSM-IVEPDS
% male NR
Race NR
Katon et al. (2004)T = 164
C = 165
58.3 years old (SD = 12),TAURegistered nurses in collaboration with the PCPMedication OR PST-PC, there is a stepped-care algorithmPHQ-9
Did not require diagnostic criteria
SCL-90 depression
35% male,
75.4% white.
Lam et al. (2009)T = 149
C = 150
71.8 years old (SD = 7.0)ACPrimary care physicians3 sessions of modified PST-PC (Mynors-Wallis et al., 2000), first session 30 to 45 minutes. session 2 & 3 20 to 30 minutes.HADS scoreHADS (AS), HADS (DS)
43.14% male,SF-36 mental
Race NR
Lynch et al. (2004)T = 9
C1 = 9
C2 = 13
38.5 years old (SD = 13.7),AC**
TAU
Registered nurses. PCP referral, no other involvement6 sessions of telephone-based PST (adopted Nezu, Nezu, & Perri, 1989)PRIME-MD
HRSD
PRIME-MD, HRSD
BDI, DHP-D-A
17% male
Race NR
McCusker et al. (2008).T = 36
C = 32
73.3 years old (SD = 8.6),TAUDepression care practitioner supervised by (and in collaboration with) PCP4 sessions PST intervention (60- minute first session, 30 mins for the rest) developed based on IMPACTPHQ-2SCL-20, SF-12
SCID
33.8% male
Race NR
Mynors-Wallis et al. (2000)T1 = 80
T2 = 35
C = 36
35 years old (SD = NR),MEDGeneral practitioner6 sessions PST-PC, with first session 1 hr, others 30 minutesRDCHDRS
23% male,Nurse and General Practitioner (PCP)HDRS scoreBDI-I
95% white
Oxman et al. (2008)T = 72
C = 69
55.2 years old (SD = 16),TAUMasters level counselor. PCP referral, no other involvement6 sessions PST-PC, with first session 1 hr, others 30 minutesDSM-IV, HAM-D,HAM-D, MADRS
HSCL-D-20
41.8% male,PRIME-MD
96.5% white
Reynolds et al. (2014)T = 125
C = 122
36.5 years old (SD = 10.9)TAUSocial workers and mental health nurses6 to 8 sessions PST-PC, with first session 1 hr, the rest 30 minutesCES-D, DSM-IV;SCID/DSM-IV;
28.7% malePCP referral, no other involvementMMSSBDI, SF-12
62.3% whiteCIRSG, BSI - Anxiety
Schmaling et al. (2002)T = 31††
C1 = 31
C2 = 30
42.8 years old (SD = 10.7)MED
Placebo
Trained therapists with no further specification6 sessions PST-PC, with first session 1 hr, others 30 minutesDSM-III-TR
PRIME-MD, HRSC
HAM-D (17-item)
HSCL-D (20-item)
39.1% malePCP referral, no other involvement
88.0% white
Williams et al. (2000)T = 138
C1 = 137
C2 = 140
71 years old (SD = 7.0),MED
Placebo
PhD Psychologists, Social workers, and Psychology Counselors6 sessions PST-PC, with first session 1 hr, others 30 minutesDSM-III-R, HDRS
DSM-IV, PRIME-MD
HSCL-D-20
HDRS
58.5% male,
78.2% whitePCP no involvement
  • * Sample size: T, treatment; T2, treatment 2 if applicable; C, control.

  • Demographic: NR, not reported.

  • Control: TAU, treatment as usual, W/NT, waitlist or no treatment; MED, medication; Placebo, placebo medication.

  • § C1, medication paroxetine; C2, Placebo.

  • Participants in the treatment group (68.7% ) received PST. Therefore, the authors believed the effect of intervention can be attributed to PST. Because sensitivity analysis that excluded this study did not alter the overall treatment effect, we included and presented this study in final analysis.

  • AC, active control (health education video).

  • ** Active control (stress management).

  • †† Specific breakdown of the numbers was not reported in article, thus assigned arbitrarily.

  • BSI, Brief Symptoms Inventory; CES-D, Center for Epidemiology Scale–Depression; DCS = depression care specialist; DFD; depression-free days; DHP-D-A, Duke Health Profile-Depression–Anxiety; EPDS, 10-item Edinburgh Postnatal Depression Scale; HAM-D, Hamilton Rating Scale for Depression; HADS, Hospital Anxiety and Depression Scale; HDRS, Hamilton Depression Rating Scale; HRSD, Hamilton Rating Scale for Depression; HSCL-D-20, Hopkins Depression self-report scale; MADRS, Montgomery-Åsberg Depression Rating Scale; MED, Medication Management; PCP, Primary Care Physician; PHQ-2, Patient Health Questionnaire, 2-item; PHQ-9, Patient Health Questionnaire, 9-item; PRIME-MD, Primary Care Evaluation of Mental Disorders; RDC, Research Diagnostic Criteria; SCL-20, Hopkins depression symptom checklist; SCL-90 depression, Hopkins Symptom Checklist—90 depression questions; SCID/DSM-IV, Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II); SF-12, SF-36 Health Survey 12-item version; TAU, Treatment as Usual; CIRSG, Cumulative Illness Rating Scale for Geriatrics.

  • Abbas M, Broadhead JC, Mbape P, Khumalo-Sakatukwa G. Defeating depression in the developing word: A Zimbabwean model. Br J Psychiatry 164(3):293–296.

  • Mynors-Wallis LM, Gath DH, Day A, Baker F. Randomised controlled trial of problem solving treatment, antidepressant medication, and combined treatment for major depression in primary care. BMJ 320:26–30.

  • Nezu A, Nezu C, Perri M. Problem-solving therapy for depression. New York: Wiley; 1989.