fear lowered mood
Conditions
Interventions
Based on a structured psychiatric interview the GPs will receive a tailor made
treatment proposal based on the Dutch multidisciplinary guideline on mood- and
anxiety disorders. Patients receiving an
Sponsors
ZonMw
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: 9 or more months of using antidepressants
Exclusion criteria
Exclusion criteria: a) current treatment in a psychiatric setting; b) history of psychosis, bipolar disorder, or obsessive compulsive disorder; c) addiction; d) recurrent depression with 3 or more episodes; e) recurrent disorders with at least two relapses after antidepressant-discontinuation.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Trial 1: proportion of participants who successfully discontinue their long-term antidepressants drug use, defined as having no antidepressant drug use within the last 6 months of the follow-up and the absence of a mood- or anxiety disorder during one-year follow-up. Trial 2: proportion of participants in which the mood or anxiety disorders present at baseline, has remitted at one-year follow-up. | — |
Secondary
| Measure | Time frame |
|---|---|
| Assessment of dimensional measures of psychopathology and in addition direct and indirect costs. - the Symptom Checklist 90-item version (SCL-90) for measuring psychological distress and global psychopathology - the Centre for Epidemiological Studies Depression Scale (CES-D) for measuring depressive symptoms - the Penn State Worry Questionnaire (PSWQ) for assessing the frequency and severity of symptoms of worrying - the Panic and Agoraphobic Scale (PAS) for measuring the severity of illness in patients with panic disorder - the Fear of Negative Evaluation Scale (FNES) for assessing expectations and distress associated with negative evaluations by others - the EuroQol-5D (EQ-5D) will be included as a utility instrument enabling the economic analyses. The EQ-5D has previously been validated and has been applied successfully in studies of mood- and anxiety disorder; - Costs will be measured by the Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness (TiC-P) - and the DESS scale will be used to assess the prevalence of the AD discontinuation syndrome. - Demographic variables (including ethnic origin) and the use of psycho-active substances (nicotine, alcohol, drugs) will be recorded at the baseline interview. - Personality characteristics and the patient-physician relationship will be examined by administration of the NEO-Five Factor Inventory (NEO-FFI) and the Patient-centeredness questionnaire, respectively. - The number of comorbid chronic somatic disorders will be assessed at baseline using the EMD of the GP. | — |
Countries
Netherlands
Outcome results
None listed