Benzodiazepines and Therapeutic Counselling Report from a WHO Collaborative Study

This book describes a unique study on the usefulness of benzodiazepine tranquilizers given in conjunction with and compared to therapeutic counselling for the treatment of minor psychiatric disorders. International collaboration under the sponsorship of the WHO made this first cross-cultural comparative study possible. Important methodological findings about measurement instruments, as well as data about the effects of different treatments, resulted from the study. It also demonstrated the possibility of using quantitative scientific methods to measure milder forms of psychiatric disorders and their changes.

1 Introduction.- 1.1 Review of the Mental Health Programme of the World Health Organization (WHO).- 1.2 Related Efforts of the Organization.- 1.3 Reasons for Undertaking a Study Using Benzodiazepines.- 1.4 Acknowledgement.- 2 Literature Review.- 2.1 Literature on Cross-Cultural Comparisons of Effectiveness of Psychotropic Drugs.- 2.2 Literature on Cross-Cultural Comparisons of Psychotherapy.- 2.3 Literature on Methodological Issues Involved in the Conduct of Comparative Studies.- 2.4 Literature About Administrative/Procedural Aspects of Multicentric Trials.- 3 Aims of the Study.- 4 Description of Materials and Methods.- 4.1 Design of the Study.- 4.2 Description of Centres at Which the Study Took Place.- 4.3 Description of Samples and Manner of Selection.- 4.4 Description of Instruments Used for Assessment and Training of Research Workers.- 4.5 Treatments.- 5 Results.- 5.1 Assessment of the Value of Instruments Used.- 5.2 Overall Comparisons Among Centres.- 5.3 Within-Centre Comparisons (Between Methods and Treatments).- 5.4 GHQ Factor Scores, Weeks 0 to 2 to 6.- 5.5 Comparison of Scores on Present State Examination.- 5.6 Treatment-Emergent Symptoms.- 5.7 Physical Measurements.- 5.8 Brief Life Events Questionnaire.- 5.9 General Summary: Effects of Drugs and Counselling.- 6 Results: Analysis of Counselling.- 6.1 Difference Among Centres in Amount of Counselling.- 6.2 Differences Among Centres in Methods of Counselling.- 6.3 Problem Areas Considered at Interview.- 6.4 Final Audit of Counselling.- 7 Discussion.- 7.1 Indirect Evaluation of Treatments.- 7.2 Evaluation of Treatments with Scales.- 7.3 General Improvement.- 7.4 Effects of the Study on Participating Centres.- 7.5 Methodological Limitations.- 7.6 Further Work.- 8 Conclusions.- References.- Appendix A: Descriptionof Research Centres and Study Areas.- Appendix B: Data Collection Forms.