David Kessler

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The UK National Institute for Clinical Excellence (NICE) Clinical Guidelines recommend routine prescription of antidepressants for moderate to severe depression. While many patients accept a prescription, one in three do not complete treatment. We carried out a meta-ethnography of published qualitative papers since 1990 whose focus is patients' experience(More)
BACKGROUND Despite strong evidence for its effectiveness, cognitive-behavioural therapy (CBT) remains difficult to access. Computerised programs have been developed to improve accessibility, but whether these interventions are responsive to individual needs is unknown. We investigated the effectiveness of CBT delivered online in real time by a therapist for(More)
Peter J. Rogers*, Katherine M. Appleton, David Kessler, Tim J. Peters, David Gunnell, Robert C. Hayward, Susan V. Heatherley, Leonie M. Christian, Sarah A. McNaughton and Andy R. Ness Department of Experimental Psychology, University of Bristol, UK Academic Unit of Primary Health Care, Department of Community Based Medicine, University of Bristol, UK(More)
OBJECTIVE To explore expectations and experiences of online cognitive behavioural therapy (CBT) among primary-care patients with depression, focusing on how this mode of delivery impacts upon the therapeutic experience. DESIGN Qualitative study, using repeat semi-structured interviews with patients before and after therapy. The study was conducted in(More)
Patients differ in their response to treatments. There is obvious clinical utility in establishing patient characteristics that are associated with differential treatment responses (i.e. are effect modifiers or moderators of treatment response). Factors that moderate response to cognitive behavioural therapy (CBT) remain unclear. This study investigates(More)
BACKGROUND Greater dietary intakes of n-3 long-chain polyunsaturated fatty acids (n-3 PUFAs) may be beneficial for depressed mood. OBJECTIVE This study aimed to systematically review all published randomized controlled trials investigating the effects of n-3 PUFAs on depressed mood. DESIGN Eight medical and health databases were searched over all years(More)
BACKGROUND Only a third of patients with depression respond fully to antidepressant medication but little evidence exists regarding the best next-step treatment for those whose symptoms are treatment resistant. The CoBalT trial aimed to examine the effectiveness of cognitive behavioural therapy (CBT) as an adjunct to usual care (including pharmacotherapy)(More)
BACKGROUND To influence GPs' prescribing policies and practices it is necessary to have an understanding of how they make decisions. The limited evidence available suggests that not only do GPs find making decisions about diagnosing and prescribing for depression problematic, but that decisions are severely constrained by lack of resources. As a result, it(More)
1 Rodin E. Vocational and educational problems with epileptic patients. Epilepsia 1972;13:149-60. 2 Jacoby A, Buck D, Baker G, McNamee P, Graham JS, Chadwick D. Uptake and costs of care for epilepsy: findings from a UK regional study. Epilepsia 1998;39:776-86. 3 Lisle JR, Waldron HA. Employees with epilepsy in the NHS. BMJ 1986;292:305-6. 4 Hart YM, Shorvon(More)
BACKGROUND Depression is more likely in patients with chronic physical illness, and is associated with increased rates of disability and mortality. Effective treatment of depression may reduce morbidity and mortality. The use of two stem questions for case finding in diabetes and coronary heart disease is advocated in the Quality and Outcomes Framework, and(More)