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BACKGROUND: We set out to investigate whether community nurses could be trained in problem-solving therapy and, once trained, how effective they would be in treating emotional disorders in primary care. METHOD: Seventy patients with an emotional disorder in primary care were randomly allocated to receive either problem-solving therapy from a trained community nurse or treatment as usual from their general practitioner. Interview and self-rated assessments of clinical and economic outcome were made pretreatment, at eight weeks and at 26 weeks after treatment. RESULTS: There was no difference in clinical outcome between patients who received problem-solving treatment and patients who received the general practitioner's usual treatment. However, patients who received problem-solving treatment had fewer disability days and fewer days off work. The health care cost of problem-solving was greater than that of the general practitioner's usual treatment but this was more than offset by savings in the cost of days off work. CONCLUSIONS: Problem-solving treatment can be given by trained community nurses. The clinical effectiveness and cost-benefit of the treatment will depend on the selection of appropriate patients.



Br J Psychiatry

Publication Date





113 - 119


Absenteeism, Adolescent, Adult, Affective Symptoms, Community Health Nursing, Cost of Illness, Cost-Benefit Analysis, Education, Nursing, England, Family Practice, Female, Health Care Costs, Humans, Male, Middle Aged, Patient Satisfaction, Problem Solving, Psychotherapy, Socioeconomic Factors, Treatment Outcome