Advice Literature on Depression: How Evidence-Based is it?

Abstract

Advice literature on depression for patients and their relatives is a widespread and low-threshold source of information. In terms of empowerment of the patients it can contribute to the early detection and effective treatment of the disorder. An evaluation of its content quality, particularly its evidence base, is still missing. Considering this, the content of advice literature on depression is reviewed by comparing it systematically with content and recommendations from the German S3-/NV-guideline on unipolar depression. Based on a systematic search within the data base of the book trade, the 30 most widespread German advice books were analysed. For this purpose a rating instrument (RLP-D) with 54 items on diagnostics and treatment was derived from the current S3-/NV-guideline. With the help of the RLP-D one rater analysed both elaboration and accuracy of the 30 books' content. Between 7.4 and 81.5% of the items i. e. of the guideline content, are missing in the analysed advice books (Mdn=25.9%, IQR=22.7%). On average a third of the 54 items is covered extensively as well as without contradictions to the guideline (Mdn=36.1%, IQR=17.1%, Range: 1.9-64.8%). A fifth of the covered items (Mdn=20.4%; IQR=19.0%, Range: 2.9-47.6%) shows clinically relevant contradictions to the guideline content. Information about psychotherapy and pharmacotherapy as treatment options is the content which is covered extensively and correctly most often: The information is given in more than 83% of the books. There is a substantial variability concerning the elaboration and accuracy of the diagnostics and treatment content in advice literature. This also applies to the especially concerning erroneous content in advice literature. The further evaluation of the rating instrument RLP-D is a next important step. An application and reduction to the core contents of the guideline could facilitate the currently rather complex and laborious rating system. Although some basic information is given in almost all of the analysed books, advice literature on depression cannot be recommended per se due to the large differences in quality. Systematic evaluations of quality should be established in order to facilitate a well-grounded choice of literature in order to improve the information for patients.