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01-01-2009 | Onderzoek
Stapsgewijze preventie van angst en depressie bij ouderen
Uitkomsten van een gerandomiseerd onderzoek
Auteurs: Nelleke van ´t Veer-Tazelaar, Harm van Marwijk, Patricia van Oppen, Hein van Hout, Henriëtte van der Horst, Pim Cuijpers, Filip Smit, Aartjan Beekman
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Samenvatting
Van ’t Veer-Tazelaar PJ, Van Marwijk HWJ, Van Oppen P, Van Hout HPJ, Van der Horst HE, Cuijpers P, Smit F, Beekman ATF. Stapsgewijze preventie van angst en depressie bij ouderen. Uitkomsten van een gerandomiseerd onderzoek. Huisarts Wet 2009;52(13):668-73.
Doel Het bepalen van de doeltreffendheid van een geïndiceerd angst- en depressiepreventieprogramma voor ouderen.
Methode Het betrof een gerandomiseerd en gecontroleerd onderzoek. Rekrutering vond plaats tussen 1 oktober 2004 en 1 oktober 2005 in 33 huisartsenpraktijken in West-Friesland. Aan dit onderzoek deden 170 ouderen (75-plus) met subklinische depressie of angst mee. We wezen de deelnemers willekeurig toe aan een preventief stapsgewijs zorgprogramma (n = 86) of aan gebruikelijke zorg (n = 84). Het stapsgewijze zorgprogramma bestond uit vier fasen: 1) watchful waiting, 2) op cognitieve gedragstherapie gebaseerde bibliotherapie, 3) het aanleren van een op cognitieve gedragstherapie gebaseerde probleemoplossingsmethode en 4) een (terug)verwijzing naar de huisarts om een eventuele medicamenteuze aanpak te bespreken. Primaire uitkomst was de cumulatieve incidentie, na een jaar, van een depressie of angststoornis die voldoet aan DSM-IV-criteria, zoals vastgesteld door middel van het Mini International Neuropsychiatric Interview (MINI).
Resultaten De interventie halveerde de eenjaarsincidentie van depressie- en angststoornissen, van 0,24 (20 van 84) in de gebruikelijke zorggroep naar 0,12 (10 van 86) in de groep die het stapsgewijze zorgprogramma aangeboden had gekregen (RR 0,49; 95%-BI 0,24 – 0,98).
Conclusie Geïndiceerde stapsgewijze preventie van depressie en angst bij ouderen halveerde het risico op het ontwikkelen van deze stoornissen. Dit onderzoek werd gefinancierd door ZonMw (2620.0003).
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Metagegevens
- Titel
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Stapsgewijze preventie van angst en depressie bij ouderen
Uitkomsten van een gerandomiseerd onderzoek - Auteurs
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Nelleke van ´t Veer-Tazelaar
Harm van Marwijk
Patricia van Oppen
Hein van Hout
Henriëtte van der Horst
Pim Cuijpers
Filip Smit
Aartjan Beekman
- Publicatiedatum
- 01-01-2009
- Uitgeverij
- Bohn Stafleu van Loghum
- DOI
- https://doi.org/10.1007/BF03085837