%0 Journal Article
%T Depression and anxiety, an Indicated Prevention (DIP) protocol in homes for the elderly: feasibility and (cost) effectiveness of a stepped care programme
%A Els Dozeman
%A Digna JF van Schaik
%A Aartjan TF Beekman
%A Wim AB Stalman
%A Judith E Bosmans
%A Harm WJ van Marwijk
%J BMC Geriatrics
%D 2007
%I BioMed Central
%R 10.1186/1471-2318-7-6
%X This protocol describes a randomised trial on the feasibility and (cost) effectiveness of a stepped-care programme for prevention of depressive and anxiety disorders in homes for the elderly. The main outcome measure is the incidence of depressive and anxiety disorder in one year with a two years follow up. Secondary outcomes are symptoms of depression and anxiety, quality of life, direct health care costs and satisfaction with treatment.The number of studies examining the effects of preventive interventions on the incidence of mental disorders in the elderly population is very small. However, indicated prevention by means of a stepped-care programme seems to be an important option for decreasing the burden of illness for residents and their caregivers. This study contributes to the body of knowledge in this field. Positive effects may contribute to further use and development of tailored, (cost-) effective and easy to use interventions in a preventive stepped-care programme.The Dutch Cochrane Centre, ISRCTN27540731In homes for the elderly, depressive and anxiety disorders are very common and have a large impact on the well-being and daily functioning of the residents. In 2002 over 90,000 of the nearly one million elderly persons in the Netherlands, aged 75 years or older, lived in a residential home [1]. Up to 30 percent of these residents develop symptoms of depression and anxiety, such as apathy and feelings of loneliness and hopelessness [2]. In about 30 to 35 percent of residents with symptoms of depression and anxiety, these symptoms eventually develop into major depression and generalised anxiety disorder [3,4]. These disorders are often associated with a poor prognosis and with excess mortality, disability, handicap and service utilisation. [5-11]. Treatment can reduce the illness burden in the population, but only to a moderate extent [12]. Therefore, prevention may be an attractive option.Indicated prevention, as opposed to universal prevention (aimed at t
%U http://www.biomedcentral.com/1471-2318/7/6