Coping with depression: a pilot study to assess the efficacy of a self-help audio cassette.

Background: The self-help audio cassette 'Coping with Depression' was produced and widely distributed as part of the national Defeat Depression Campaign. A central aim was to improve public understanding and encourage the use of cognitive-behavioural techniques.

Aim: To formally assess the ability of the audio cassette to change attitudes to depression in primary care and the degree to which patients are motivated to practice its recommended coping strategies.

Design Of Study: Comparison of Likert ratings of agreement completed by patients, before and after listening to the audio cassette at home.

Setting: General practitioners (GPs) in central Leeds chosen randomly from the 1998 West Yorkshire Practice Directory.

Method: Fifty out of 71 patients aged over 16 diagnosed as depressed by their GP completed the hospital anxiety and depression (HAD) Scale and Likert ratings of agreement with key messages on the audio cassette. General practitioners provided feedback on the utility of the audio cassette in routine practice.

Results: A clinically significant improvement in overall attitudes and knowledge of 13% (95% confidence interval = 7-20%, P = 0.001) was seen. Negative attitudes decreased most among those not taking antidepressants (P = 0.007). Hearing a description of depressive symptoms and practical advice on coping were rated as the main benefits. Thirty (60%) patients stated that they had already begun to try out the cognitive-behavioural suggestions within the first week.

Conclusions: Larger randomised controlled trials are needed to confirm the efficacy of self-help audio cassettes for depression. This tape may be most helpful to patients with negative attitudes towards treatment, especially those who initially decline antidepressant medication.