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Randomized Controlled Trial
. 2011 Oct 11:12:225.
doi: 10.1186/1745-6215-12-225.

A randomised evaluation of CollAborative care and active surveillance for Screen-Positive EldeRs with sub-threshold depression (CASPER): study protocol for a randomized controlled trial

Natasha Mitchell  1 , Catherine Hewitt, Joy Adamson, Steve Parrott, David Torgerson, David Ekers, John Holmes, Helen Lester, Dean McMillan, David Richards, Karen Spilsbury, Christine Godfrey, Simon Gilbody
Affiliations
Randomized Controlled Trial

A randomised evaluation of CollAborative care and active surveillance for Screen-Positive EldeRs with sub-threshold depression (CASPER): study protocol for a randomized controlled trial

Natasha Mitchell et al. Trials. .

Abstract

Background: Depression accounts for the greatest burden of disease among all mental health problems, and is expected to become the second-highest amongst all general health problems by 2020. By the age of 75, 1 in 7 older people meet formal diagnostic criteria for depression. Efforts to ameliorate the burden of illness and personal suffering associated with depression in older people have focussed on those with more severe depressive syndromes. Less attention has been paid to those with mild disorders/sub-threshold depressive syndromes but these patients also suffer impairments in their quality of life and level of functioning.

Methods/design: The CASPER study has been designed to assemble an epidemiological cohort of people over 75 years of age (the CASPER cohort), from which we will identify those eligible to participate in a trial of collaborative care for sub-threshold depression (the CASPER trial).We aim to undertake a pragmatic randomised controlled multi-centre trial evaluating the effectiveness and cost-effectiveness of collaborative care; a low intensity psychological intervention in addition to usual general practitioner care versus usual general practitioner care alone. General practitioners from practices based in the North of England will be asked to identify potentially eligible patients over the age of 75 years. Patients will be sent a letter inviting them to participate in the study.We aim to recruit approximately 540 participants for the CASPER trial. A diagnostic interview will be carried out to ascertain trial eligibility with the major depressive episode module of the Mini International Neuropsychiatric Interview (M.I.N.I.), eligible participants randomised to either the intervention or usual care. The primary outcome will be measured with the Patient Health Questionnaire-9 (PHQ-9) and additional quality of life measures will be collected. Data will be collected at baseline, 4 and 12 months for both trial and cohort participants.

Trial registration: ISRCTN: ISRCTN02202951.

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Figures

Figure 1
Figure 1
The Whooley Questions. The Whooley questions.
Figure 2
Figure 2
Flowchart of the CASPER study. Flowchart of the CASPER study.
Figure 3
Figure 3
Diagnostic criteria for depression based on DSM-IV. Diagnostic criteria for depression based on DSM-IV.
See this image and copyright information in PMC

References

    1. Murray C, Lopez A. The global burden of disease: a comprehensive assessment of mortality and disability from disease, injuries and risk factors in 1990. Boston, Massachusetts: Harvard School of Public Health on behalf of the World Bank; 1996.
    1. Chew-Graham C, Baldwin R, Burns A. Treating depression in later life. BMJ. 2004;329(7459):181–182. doi: 10.1136/bmj.329.7459.181. - DOI - PMC - PubMed
    1. Rapp S, Parisi S, Walsh D. Psychological dysfunction and physical health among elderly medical inpatients. Journal of Consulting and Clinical Psychology. 1988;56(6):851–855. - PubMed
    1. Walker Z, Leek C, D'ath P, Katona C. Psychiatric morbidity in elderly attenders at an accident and emergency department. International Journal of Geriatric Psychiatry. 1995;10(11):951–957. doi: 10.1002/gps.930101107. - DOI
    1. National Institute for Health and Clinical Excellence. The Treatment and Management of Depression in Adults. London: NICE; 2009.

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