***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We performed a r and omized controlled study to evaluate  computer-based cognitive behavioral therapy in 36 patients who met Research Diagnostic Criteria for major or minor depression . Patients were r and omly assigned to the computer , to a therapist , or to a control group placed on a waiting list . As determined by three measures of depression ( the Beck inventory , the Hamilton rating scale , and the Symptom Checklist-90-R ) , both treated groups had improved significantly more than the control group at the end of the treatment period and 2 months later . The treated groups did not differ from each other at either time BACKGROUND Counselling in primary care setting s remains largely unevaluated . Such evaluation has been strongly recommended . AIM To determine the relative effectiveness and cost-effectiveness of generic counselling and usual general practitioner ( GP ) care for patients with minor mental health problems . METHOD A r and omized controlled trial and health economic evaluation were carried out in nine general practice s.  Access to generic counselling ( brief counselling , generally involving up to six 50-minute sessions ) was compared with usual GP care .  A total of 162 patients aged 16 years and over with diverse mental health problems ( excluding phobic conditions and psychoses ) were r and omized . The Hospital Anxiety and Depression ( HAD ) scale , COOP/WONCA ( World Organization of Family Doctors ) functional health assessment charts , and the delighted-terrible faces scale were used to assess outcome four months after r and omization . RESULTS The two groups were similar at baseline . There were significant improvements in both groups between r and omization and follow-up for most outcome measures , but no significant differences between the study arms . The 95 % confidence limits were narrow and excluded clinical ly significant effects . Under various assumptions concerning the cost of secondary care referrals and of counselling time , no clear cost advantage was associated with either intervention . CONCLUSIONS This pragmatic trial demonstrates no difference in functional or mental health outcome at four months between subjects offered access to counselling and those given usual care by their GP . There is no clear difference in the cost-effectiveness of the two interventions . Purchasers should take account of these findings in allocating re sources within primary care Abstract Objective : To compare the clinical effectiveness of general practitioner care and two general practice based psychological therapies for depressed patients . Design : Prospect i ve , controlled trial with r and omised and patient preference allocation arms . Setting : General practice s in London and greater Manchester . Participants : 464 of 627 patients presenting with depression or mixed anxiety and depression were suitable for inclusion . Interventions : Usual general practitioner care or up to 12 sessions of non-directive counselling or cognitive-behaviour therapy provided by therapists . Main outcome measures : Beck depression inventory scores , other psychiatric symptoms , social functioning , and satisfaction with treatment measured at baseline and at 4 and 12 months . Results : 197 patients were r and omly assigned to treatment , 137 chose their treatment , and 130 were r and omised only between the two psychological therapies . All groups improved significantly over time . At four months , patients r and omised to non-directive counselling or cognitive-behaviour therapy improved more in terms of the Beck depression inventory ( mean ( SD ) scores 12.9 ( 9.3 ) and 14.3 ( 10.8 ) respectively ) than those r and omised to usual general practitioner care ( 18.3 ( 12.4 ) ) . However , there was no significant difference between the two therapies . There were no significant differences between the three treatment groups at 12 months ( Beck depression scores 11.8 ( 9.6 ) , 11.4 ( 10.8 ) , and 12.1 ( 10.3 ) for non-directive counselling , cognitive-behaviour therapy , and general practitioner care ) . Conclusions : Psychological therapy was a more effective treatment for depression than usual general practitioner care in the short term , but after one year there was no difference in outcome The aim of this study was to evaluate the effectiveness of 2 methods of administering a cognitive-behavioral self-help program for binge eating disorder . The study was design ed to reproduce many of the conditions that apply in setting s in which self-help interventions are most relevant . Seventy-two women with binge eating disorder were r and omly assigned to 1 of 3 conditions for 12 weeks : pure self-help ( PSH ) , guided self-help ( GSH ) , or a waiting list ( WL ) control condition ( followed by PSH or GSH ) . They were then followed up for 6 months . Both PSH and GSH had a substantial and sustained impact with almost half the participants ceasing to binge eat . There was little change in the WL condition . Cognitive-behavioral self-help may be of value both as an initial treatment for binge eating disorder and as a form of secondary prevention Behavioural methods of treating anxiety have been shown to be highly effective but are not widely available in general practice where most people suffering from anxiety are treated . This study reports a development in service delivery which is simple , inexpensive and does not make great time dem and s on general practitioners or require them to extend their training and expertise . The study shows that for patients suffering from panic disorder or generalized anxiety disorder the use of an anxiety management booklet in addition to their usual treatment from their general practitioner produces clinical ly and statistically significant improvements . Of particular importance is the speed of response to the booklet . Within the first two weeks those patients who received the booklet were significantly less anxious than the controls . The booklet was acceptable to patients and recommendations are made about how to incorporate it into clinical practice The efficacy of a self-help package in treating  chronic anxiety  was evaluated in a r and omized controlled trial in which the intervention group received self-help material s in the form of an audiotape and booklet , in addition to their current treatment . The intervention was successful in terms of mean depression scores ( P = 0.01 ) , anxiety scores ( P = 0.04 ) and general health question naire scores ( P = 0.02 ) which were significantly lower for the intervention group than for the controls . In addition , the depression scores fell faster for the intervention group than for the controls . The overall mean reduction in three months in adjusted depression scores was approximately two points greater for the intervention group than for the controls ( P = 0.02 ) . Clinicians welcomed the package as a valuable addition to the therapies available for managing chronic anxiety problems . Further studies should include larger sample sizes , taking into account the non-response to postal question naires over time The efficacy of cognitive bibliotherapy for adolescents experiencing mild and moderate depressive symptomatology was examined with a group of 22 community-dwelling adolescents .  Cognitive bibliotherapy was determined to be superior to a delayed-treatment control condition . The treatment produced both statistically and clinical ly significant improvements in depressive symptoms . Treatment gains were maintained at 1-month follow-up . A significant decrease in dysfunctional thoughts , but not in negative automatic thoughts , was found after treatment . These results contribute to converging evidence on the efficacy of cognitive-behavioral treatments for adolescents experiencing depressive symptoms A controlled trial study which examined the clinical effectiveness of a stress self-help package administered by general practitioners to patients presenting with psychological problems which were potentially stress-related is described . Patients were r and omly allocated to one of two groups : existing general practitioner treatment with or without the use of the package . Significant advantages were found for patients who received the package compared with controls in both their level of symptoms at three-month follow-up and their rate of consulting for psychological problems in the three-month post-treatment period compared with the three-month pre-treatment period . The potential use of such packages in the treatment of psychological problems in primary care is discussed OBJECTIVE This study assessed relationships among psychological symptoms , past and current psychiatric disorder , functional impairment , somatic symptoms , chronic fatigue , and chronic fatigue syndrome . METHOD A prospect i ve cohort study was followed by a nested case-control study . The subjects , aged 18 - 45 years , had been in primary care for either clinical viral infections or a range of other problems .  Question naire measures of fatigue and psychological symptoms were completed by 1,985 subjects 6 months later ; 214 subjects with chronic fatigue were then compared with 214 matched subjects without fatigue . Assessment s were made with question naires , interviews , and medical records of fatigue , somatic symptoms , psychiatric disorder , and functional impairment . RESULTS Subjects with chronic fatigue were at greater risk than those without chronic fatigue for current psychiatric disorder assessed by st and ardized interview ( 60 % versus 19 % ) or by question naire ( 71 % versus 31 % ) . Chronic fatigue subjects were more likely to have received psychotropic medication or experienced psychiatric disorder in the past . There was a trend for previous psychiatric disorder to be associated with comorbid rather than noncomorbid chronic fatigue . Most subjects with chronic fatigue syndrome also had current psychiatric disorder when assessed by interview ( 75 % ) or question naire ( 78 % ) . Both the prevalence and incidence of chronic fatigue syndrome were associated with measures of previous psychiatric disorder . The number of symptoms suggested as characteristics of chronic fatigue syndrome was closely related to the total number of somatic symptoms and to measures of psychiatric disorder . Only postexertion malaise , muscle weakness , and myalgia were significantly more likely to be observed in chronic fatigue syndrome than in chronic fatigue . CONCLUSIONS Most subjects with chronic fatigue or chronic fatigue syndrome in primary care also meet criteria for a current psychiatric disorder . Both chronic fatigue and chronic fatigue syndrome are associated with previous psychiatric disorder , partly explained by high rates of current psychiatric disorder . The symptoms thought to represent a specific process in chronic fatigue syndrome may be related to the joint experience of somatic and psychological distress 
    Output:
    
There were no data concerning long-term clinical benefits or cost-effectiveness .
In conclusion , self-help treatments may have the potential to improve the overall cost-effectiveness of mental health service provision .