Effectiveness of Peer Support in Treating Depression

A meta-analysis was carried out to evaluate the role of support provided by friends and colleagues in reducing the intensity of depression. Data from 10 different randomized controlled trials were analyzed to understand the changes due to incorporation of peer support in routine psychotherapy sessions. The reviewers state that they especially wanted to evaluate if “peer support interventions result in greater reduction of depression symptoms compared to either usual care or psychotherapy.” The results proved peer support to have a positive effect.

One of the most frequently encountered psychological illnesses is depression, which not only affects your quality of life but ultimately also your financial status. Although several antidepressants are available, either their effects are insufficient or are temporary, thus other supportive therapy treatments need to be added. Peer support has been found effective in accelerating standard treatment for depression. This essentially involves people who are depressed or have been depressed in the past exchanging their experiences with patients of depression to enable a better understanding of solutions. Relating to like-minded people definitely gets rid of loneliness, buffers stress inputs, encourages exchange of health information and motivates self-care. Group therapy also provides role models to follow. Despite these benefits, peer support as an adjunct to regular therapy for depression is not the norm yet because of lack of organized evidence regarding its effectiveness. This meta-analysis was conducted to put forward a strong “evidence base” for peer support as an influence in treating depression.

From online medical trial registries, the reviewers shortlisted controlled trials with randomization into two groups—the usual psychotherapy models or peer support models. The reviewers ensured that these studies included only patients with current depression that was measurable pre- and post-study. From an initial selection of almost 800 studies, after various exclusions, 10 trials were finally selected to be reviewed. Measures of depression were calculated for each group and compared statistically to obtain overall results on the basis of gender and the criteria of measurement.

Key findings
* When seven randomized studies involving 849 subjects were reviewed for comparison between usual care given for depression and intervention by means of support from friends and peers, the latter method reduced the symptoms of depression much more effectively.
* On comparing peer support intervention with cognitive therapy (another standard treatment for depression) in 301 patients in seven trials, it was found that the effects of both the approaches were very similar.
* Overall, intervention by supportive friends and peers was seen to be beneficial in reducing symptoms of depression.

Shortcomings/next steps
The major limitations of this meta-analysis were the inclusion of depressed subjects with varied medical histories, inadequate studies, doubtful reliability of cognitive therapy structures, etc. The analysts also state that focusing only on peer-reviewed articles, they may have missed some significant studies. Going ahead, it is important to include larger trials representing a wider range of subjects, appropriate schedules of peer support intervention and variability between patients.

The results of this meta-analysis support the view that people who have partially or completely overcome symptoms of a depressive disorder can be instrumental in effectively helping patients with current symptoms of depression. In fact, peer support and mutual counseling has won over the standard care practices and even cognitive behavioral therapy. Hence, it is important to incorporate peer group counseling sessions as integral or additional sections of psychotherapy for major depressive disorders. The extent of social, economic and psychological pressures contributing to depression across the globe is compelling to initiate immediate and adequate action. It also becomes essential to moderate the cost implications of treatment while enhancing availability of support therapy for a widespread issue such as depression.

For More Information:
Efficacy of Peer Support Interventions for Depression: A Meta-Analysis
Publicaiton Journal: General Hospital Psychiatry, 2011
By Paul N. Pfeiffer, MD; Michele Heisler, MD; Department of Veteran Affairs, Ann Arbor, Michigan, and the University of Michigan, Ann Arbor

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