To provide reliable and valid data on the prevalence, risk factors and outcome of depressive illness in rural and urban settings within the European community based on an epidemiological sampling frame.
To assess the impact of a person-centred preventive approach on the outcome of depression and on service utilisation and costs.
Five centres across the EU with expertise in mental health epidemiology and interventions will participate in this study. Suitable urban and rural areas will be identified in each centre. The sampling frame will be adults aged 18-64, identified via primary care data bases or electoral registers. A two stage screening procedure will be adopted. In the first stage potential cases of depressive illness and depressive adjustment disorder will be identified using the Beck Depression Inventory (BDI), and data will be gathered on life events, social support and sociodemographic details. Those scoring above cutoff on the BDI and a random 5% total sample will be offered a detailed interview by mental health trained researchers. This will use SCAN2 to assign caseness against DSMIV and ICD10 criteria; assess co-morbidity, disability, genetic/familial susceptibility, psychosocial stressors, personality traits and cognitive factors; and assess provision and utilisation of local health care services.
A randomised controlled trial of person-centred prevention will be undertaken for respondents identified as cases of depression/depressive adjustment disorder. This will have three arms. 1: Individual intervention: a community mental health facilitator (MHF) will provide individual training in problem solving approaches. 2: Group intervention: as above, but group rather than individual training in problem solving approaches. 3: A control group with no intervention from the research project.
Subjects will be followed-up at 6 and 12 months to assess outcome for subjects and health care utilization.
Funding SchemeCSC - Cost-sharing contracts
6500 HE Nijmegen