Is collaborative care more clinically and cost effective than usual care in the management of patients with moderate to severe depression in UK primary care?

Not Applicable

Completed

• Conditions: Depression; Mental and Behavioural Disorders; Depressive episode

• Registration Number: ISRCTN32829227
• Lead Sponsor: niversity of Exeter (UK)

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2008-11-28
• Last Update Posted: 17 October 2016

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 550

Inclusion Criteria

We will include patients (both males and females) meeting the diagnostic criteria for depression who are aged 18 years and above and who are not currently receiving treatment for depression from specialist mental health services. We will establish the diagnosis of depression by the use of the Clinical Interview Schedule (CIS-R) undertaken by a research worker. We wish our trial to reflect the real world as closely as possible by including all patients with depression; we will therefore include both patients newly identified as depressed, with or without one or more previous depressive episodes, and those with a current depressive illness which has not responded to primary care management in the previous four months. We will also include patients who are suffering from peri- or post-natal depression, with either co-morbid physical illness or co-morbid non-psychotic functional disorders, such as anxiety. In line with the pragmatic nature of this trial, we will reflect usual GP care and participants will be eligible to participate whether they are in receipt of antidepressant medication or not.

Exclusion Criteria

1. Patients whose risk of suicide is sufficiently acute to demand immediate management by a crisis team. Case managers will be trained to recognise and manage less acute risk through applying the procedures taught in the STORM (Skills-based Training On Risk Management) training, we will follow the trial suicide protocol. We will ensure that the patient's GP is involved immediately so they can take appropriate action for patients with suicidal plans.
2. Psychotic patients
3. Patients where the low mood is better explained by a simple bereavement reaction
4. Patients whose primary presenting problem is alcohol or drug abuse

Study & Design

• Study Type: Interventional
• Study Design: Not specified