Intervention development for the indicated prevention of depression in later life: The “DIL” protocol in Goa, India

Contemporary Clinical Trials Communications

卷:6

Jennifer Morse, PhD¹  Pim Cuijpers, PhD²  Vikram Patel, MD, PhD³  Alex Cohen, PhD³  Amit Dias, MD⁴  Fredric Azariah, MSc Public Health⁵  Salvino Soares, MCom⁵  Vithoba Gaude, MBA⁵  Miriam Sequeira, MA Psychology⁵  Stewart Anderson, PhD⁶  Charles F. Reynolds, III, MD⁷ 

[1] Chatham College, Pittsburgh, PA, USA;

[2] Free University, Amsterdam, The Netherlands;

[3] London School of Hygiene and Tropical Medicine, United Kingdom;

[4] SANGATH and Goa Medical College, India;

[5] SANGATH, Goa, India;

[6] University of Pittsburgh Graduate School of Public Health, USA;

[7] University of Pittsburgh School of Medicine and Graduate School of Public Health, USA;

关键词: Indicated depression prevention;    Lay health counsellor;    Low- and middle-income countries (LMICs);   

DOI  :  10.1016/j.conctc.2017.04.006

来源: DOAJ

【 摘 要 】

Because depression is a major source of the global burden of illness-related disability, developing effective strategies for reducing its incidence is an important public health priority, especially in low-income countries, where resources for treating depression are scarce. We describe in this report an intervention development project, funded by the US National Institute of Mental Health, to address “indicated” prevention of depression in older adults attending rural and urban primary care clinics in Goa, India. Specifically, participants in the “DIL” (“Depression in Later Life”) trial were older adults living with mild, subsyndromal symptoms of depression and anxiety and thus at substantial risk for transitioning to fully syndromal major depression and anxiety disorders. Building upon the MANAS treatment trial (“Promoting Mental Health”) led by Patel et al. in the same locale, we present here lessons learned in the development and implementation of a protocol utilizing lay health counsellors (LHCs) who deliver a multi-component depression prevention intervention organized conceptually around Problem Solving Therapy for Primary Care (PST), with additional components addressing brief behavioural treatment of sleep disturbances such as insomnia, meeting basic social casework needs, and education in self-management of prevalent comorbid chronic diseases, such as diabetes mellitus. To our knowledge, DIL is the first randomized clinical trial addressing the prevention of depressive disorders ever conducted in a low- or middle-income country.

【 授权许可】

Unknown