No registrations found.
ID
Source
Brief title
Health condition
Depressive disorders (major and minor), Anxiety disorders (major and minor).
Sponsors and support
Intervention
Outcome measures
Primary outcome
Speed of recovery in terms of symptom reduction (QIDS for depression, and the HADS-A for anxiety) at baseline and after 8, 16 and 24 weeks.
Secondary outcome
At baseline and after 8, 16 and 24 weeks:
1. DSM diagnosis (CIDI);
2. Quality of life (SF36 and Euroqol);
3. The use of health care services (TIC-P);
4. The use of medication (TIC-P);
5. Productivity losses (TIC-P);
6. Satisfaction with delivered care / continuity of care (Quote).
Background summary
Primary care patients with depressive and / or anxiety disorders are randomly assigned to stepped care or care as usual. Stepped care consists of 4 interventions of increasing intensity: (1) watchful waiting (2) bibliotherapy (3) problem solving therapy (4) medication and / or psychotherapy in mental health care. Patients will be monitored at baseline and after 8, 16 and 24 weeks on primary outcomes (symptoms of depression and anxiety) and secondary outcomes (quality of life, use of health care services, medication use, productivity loss, satisfaction with care / continuity of care.
Study objective
A stepped care program in primary care for patients with depressive and/or anxiety disorders is more effective than care as usual.
Intervention
In the current study a stepped care program will be developed for primary care patients with anxiety and/or depression. A stepped care program is characterized by different steps of treatment that are arranged in order of increasing intensity. After each step, the patient will be monitored, to determine if symptoms have been sufficiently reduced. The program consists of evidence based interventions: 1. Watchful waiting;
2. Bibliotherapy;
3. Problem solving treatment;
4. Medication and/or an evidence based treatment in specialised mental health care.
The control condition is care as usual.
Van der Boechorststraat 1
Laura Kool
Van der Boechorststraat 1
Amsterdam 1081 BT
The Netherlands
+31 (0) 20 5982544
lm.kool@psy.vu.nl
Van der Boechorststraat 1
Laura Kool
Van der Boechorststraat 1
Amsterdam 1081 BT
The Netherlands
+31 (0) 20 5982544
lm.kool@psy.vu.nl
Inclusion criteria
They are recruited through screening (all patients who visited their GP). They have to meet the following criteria:
1. Between 18-65 years;
2. A DSM diagnosis of minor depression, major depression, dysthymia, panic disorder (with or without agoraphobia), generalised anxiety disorder, or social phobia. Patients with minor anxiety (not fulfilling any DSM criteria of an anxiety disorder) will also be included.
Exclusion criteria
Patients are excluded if they:
1. Have psychotic or bipolar symptoms;
2. Have a high suicide risk;
3. Are currently under treatment or received treatment for depression/anxiety in the past twelve months;
4. Cannot read or write Dutch sufficiently enough to complete the questionnaires.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| NTR-new | NL787 |
| NTR-old | NTR799 |
| Other | : N/A |
| ISRCTN | ISRCTN17831610 |