Chronic or recurrent depression in primary care Mental and Behavioural Disorders Depression
Conditions
Interventions
Comparison is between 'GP usual care' (control), versus a 'structured care' approach involving regular practice nurse follow up (intervention).
1. Intervention group:
The intervention being studied
Sponsors
University College London (UCL) (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Men and women aged 18 years or above 2. GP diagnosis of depression with at least two documented episodes of depression in the previous 3 years, or chronic depression/dysthymia over a 2-year period 3. Evidence of recurrent and/or chronic depression via Composite International Diagnostic Interview (CIDI) (lifetime) questionnaire 4. Baseline Beck Depression Inventory II (BDI II) score of 14 or above (indicating at least mild depression) 5. Sufficient English to be able to complete a self-report questionnaire
Exclusion criteria
Exclusion criteria: 1. Current psychotic symptoms 2. Severe cognitive impairment (patient unable to complete questionnaires) 3. Incapacitating alcohol or drug dependence 4. Under 18 years of age 5. Patient needs an interpreter to translate information sheets and questionnaires
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome measure is the Beck Depression Inventory II (BDI II). The BDI II is a much used, reliable and well-validated measure for both the identification of depression severity and monitoring its clinical outcome, which has been used in many primary care studies. This will be measured at baseline and 3-monthly throughout the study period. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Depression-free days: to be calculated using BDI assessment scores following the method of Lave et al. This will be compared with patients' records of the number of days that they were sufficiently depressed for it to have affected their functioning or not, mood diary to be completed daily by participants 2. Social functioning: measured using the Work and Social Adjustment Scale (WSAS), measured at baseline and final assessment 3. Frequency of depressive episodes: will be collected via the CIDI questionnaire, measured at baseline and final assessment 4. Personality variables: to be measured using the SAPAS (Standardised Assessment Personality Abbreviated Scale), measured at baseline only 5. Quality of life: will be measured by the Euroquol EQ-5D, measured at baseline and at final assessment 6. Resource use and costs: data on services used and productivity losses will be collected using a modified version of the Client Service Receipt Inventory (CSRI), measured at baseline and final assessment 7. Practice service data | — |
Countries
United Kingdom
Outcome results
None listed