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Dates: 2000 - completed 2004
Funding: NHS Research & Development Programme
Collaborators: Department of Primary Care, University of Southampton
Information: Oliver Rivero-Arias

This was a pragmatic randomised clinical trial of problem solving by community mental health nurses (CMHNs) for anxiety, depression and life difficulties among general practice patients. The objectives of the study were:

  • To compare the effectiveness of CMHN problem-solving and generic CMHN care, against usual GP care in reducing symptoms, alleviating problems, and improving social functioning and quality of life.

  • To undertake a cost-utility analysis comparison of each CMHN treatment compared to usual GP care, evaluating not only direct costs of treatment but also patient costs, including time off work.

A full article with the effectiveness and cost-effectiveness results of the study was published in the British Journal of Psychiatry in 2006. A Health Technology Assessment report is also available with additional data from the study.

The study showed no difference in effectiveness among groups at any of the follow-up periods. Costs were significantly higher in the CMHN groups when compared to general practice. It was concluded that GPs should not refer unselected patients with common mental disorders to specialist nurses unless patients have not responded to initial GP care.


Kendrick T, Simons L, Mynors-Wallis L, Gray A, Lathlean J, Pickering R, Harris S, Rivero-Arias O, Gerard K, Thompson C (2006). Randomised controlled trial and cost-effectiveness analysis comparing usual GP care for common mental disorders versus referral for generic care, or problem solving treatment, from community mental health nurses (CPN-GP Study). British Journal of Psychiatry 189(1):50-59.

Kendrick, T, Simons, L, Mynors-Wallis, L, Gray, A, Lathlean, J, Pickering, R, Harris, S, Rivero-Arias, O, Gerard, K and Thompson, C (2005). A trial of problem-solving by community mental health nurses for anxiety, depression and life difficulties among general practice patients. The CPN-GP study. Health Technol Assess 9(37):1-104, iii.

Simons L, Mynors-Wallis L, Pickering R, Gray A, Brooking J, Thompson C, Kendrick T (2001). A Randomized Controlled Trial of Problem Solving for Anxiety, Depression and Life Difficulties by Community Psychiatric Nurses Among General Practice Patients: Background and Method. Primary Care Psychiatry 7(4):129-135.