Stepped-care to prevent depression and anxiety in visually impaired older adults--design of a randomised controlled trial

Subthreshold depression and anxiety are common in the growing population of visually impaired older adults and increase the risk of full-blown depressive or anxiety disorders. Adequate treatment may prevent the development of depression or anxiety in this high risk group. A stepped-care programme wa...

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Bibliographic Details
Published in:BMC psychiatry 2013-08, Vol.13 (1), p.209-209, Article 209
Main Authors: van der Aa, Hilde P A, van Rens, Ger H M B, Comijs, Hannie C, Bosmans, Judith E, Margrain, Tom H, van Nispen, Ruth M A
Format: Article
Language:English
Subjects:
Aged
Anxiety
Anxiety - economics
Anxiety - prevention & control
Anxiety - psychology
Anxiety Disorders - economics
Anxiety Disorders - prevention & control
Anxiety Disorders - psychology
Clinical Protocols
Clinical trials
Cost-Benefit Analysis
Depression - economics
Depression - prevention & control
Depression - psychology
Depression, Mental
Depressive Disorder - economics
Depressive Disorder - prevention & control
Depressive Disorder - psychology
Evidence-based medicine
Female
Humans
Male
Middle Aged
Prevention
Primary Health Care - economics
Psychiatry
Psychological aspects
Research Design
Study Protocol
Visually Impaired Persons - psychology
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Summary:Subthreshold depression and anxiety are common in the growing population of visually impaired older adults and increase the risk of full-blown depressive or anxiety disorders. Adequate treatment may prevent the development of depression or anxiety in this high risk group. A stepped-care programme was developed based on other effective interventions and focus groups with professionals and patient representatives of three low vision rehabilitation organisations in The Netherlands and Belgium. The final programme consists of four steps: 1) watchful waiting, 2) guided self-help, 3) problem solving treatment, 4) referral to general practitioner. The (cost-)effectiveness of this programme is evaluated in a randomised controlled trial. Patients (N = 230) are randomly assigned to either a treatment group (stepped-care) or a control group (usual care). The primary outcome is the incidence of depressive and anxiety disorders, measured with the Mini International Neuropsychiatric Interview (MINI). Preventive interventions for depression and anxiety have received little attention in the field of low vision. A stepped-care programme that focuses on both depression and anxiety has never been investigated in visually impaired older adults before. If the intervention is shown to be effective, this study will result in an evidence based treatment programme to prevent depression or anxiety in patients from low vision rehabilitation organisations. The pragmatic design of the study greatly enhances the generalisability of the results. However, a possible limitation is the difficulty to investigate the contribution of each individual step. Identifier: NTR3296.
ISSN:1471-244X
1471-244X
DOI:10.1186/1471-244X-13-209