Screening and Treatment of Depression in the Community

NCT00430404 | Completed Phase 4

• 1 other identifier: NMRC/0846/2004
• Study Type: interventional
• Target: 214
• Locations: 1 country
• Sites: 1

Brief Summary

To evaluate the effectiveness of a community-based strategy of routine population mass screening for depression with follow-up feedback and management in a primary care non-psychiatric setting involving a structured, multifaceted, collaborative (primary care and hospital-based)shared care programme. Hypotheses: We hypothesize that a community-based early psychiatric interventional strategy (CEPIS) for depression in the elderly leads to increased recognition of depression by primary care physicians, more initiation of treatment for emotional problems, and improved outcomes for patients with depression, as measured by:

1. 1.increased rates of detection or recognition by a primary care physician of minor or major (clinical) depression.
2. 2.higher rates of management activities: counselling for psychological, family social problems, contact with community family services (human service agency), consultation and/or referral to a mental health specialist
3. 3.Reduced depressive symptom severity, improved level of daily functioning and quality of life among those with major clinical depression
4. 4.Better patient satisfaction with care
5. 5.Favourable clinician's and patients perception of their usefulness or acceptability

Conditions

Depression

Outcome Measures

Primary Outcomes (1)

• Response to treatment at 6 months follow up is defined as a 50% reduction in HAMD-17 score

  After enrolled in the study for 6 months, depressive symptoms were expected to reduce to 50% in assessment fo HAM\_D 17

  6 months

Secondary Outcomes (5)

• Rates of physician and patient self-report of service utilization at 6 month follow up

  6 months

• Improvement in follow-up SF-12 scores from baseline

  12 months

• Caregiver burden at 6 month follow-up

  6 months

• Patient satisfaction with care at 6 month follow up

  6 months

• Physician feedback at 6 month follow up

  6 months

Study Arms (2)

Usual care (controlled group)

NO INTERVENTION

Usual care for management of depression

collaborative care (Intervention)

EXPERIMENTAL

Collaborative care for management of depression for intervention group. We provided multidisciplinary groups of care from psychiatrist, psychologist, social counselor, general practitioners and case managers for intervention group.

Other: Collaborative care (Intervention)

Interventions

Collaborative care (Intervention) OTHER

Structured shared care with treatment protocol \& support

Also known as: Community based early psychiatric intervention strategy

collaborative care (Intervention)

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \> 60 years without dementia,
• Major depressive disorder,
• Bipolar disorder,
• Dysthymia disorder,
• Anxiety disorder,
• Mania/hypomania

You may not qualify if:

• Severe post-stroke dementia or aphasia,
• History of mania, psychiatric consultation or admission to hospital in past 3 months,
• MMSE score \<18,
• Fully dependent at 3 or more basic activities of daily living,
• Very high BDI score (\>=30),
• Serious suicidal risk,
• Current psychotic symptoms,
• Current alcohol abuse,
• Very high GDS score (\>=12) confirmed by SCID

Sponsors & Collaborators

• National University Hospital, Singapore: lead
• National University of Singapore: collaborator

Study Sites (1)

Department of Psychological Medicine, National University Hospital, 5 Lower Kent Ridge Road

Singapore, 119074, Singapore

Location

MeSH Terms

Conditions

Depression

Interventions

Methods

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior

Intervention Hierarchy (Ancestors)

Investigative Techniques

Study Officials

• Ng Tz Pin, MD,MFPHM

  Gerontological Research Programme, Faculty of Medicine, National University of Singapore

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Ng Tz Pin, MD, MFPHM, National University Hospital, Singapore

Study Record Dates

• First Submitted: January 31, 2007
• First Posted: February 1, 2007
• Study Start: August 1, 2004
• Primary Completion: August 1, 2007
• Study Completion: September 1, 2007
• Last Updated: January 3, 2014

Record last verified: 2014-01

Locations

SG (1)