Effectiveness of the Coping With Depression (CWD) course for older adults provided by the community-based mental health care system in the Netherlands: a randomized controlled field trial.

Full Abstract

BACKGROUND: The Dutch version of the Coping With Depression (CWD) course for older adults has been implemented in the prevention arm of the community-based mental health care system in the Netherlands. The study group included older adults with subclinical depression as well as those with a major depressive disorder; all were enrolled into the course by mental health care professionals. The effectiveness (immediate and long-term) of the course for this heterogeneous population was studied in an effectiveness trial. METHOD: Participants were self-referred, responding to media announcements. A total of 119 participants aged 55-85 years (69% female), with subclinical depression and major depression, were randomized to either the CWD course (N = 61) or the waiting list (N = 58). RESULTS: Nine participants dropped out of the course. According to a diagnostic interview based on the DSM-IV, 39% had a major depressive disorder (MDD), 69% had had a previous MDD, and 45% had an anxiety disorder. Older adults in the intervention group showed a significant decrease in depression symptoms. Gains were maintained over 14 months. In the intervention condition 83% had a pre-treatment score > or = 16 on the Center for Epidemiologic Studies Depression Scale (CES-D); at post-treatment 62% still scored > or = 16. CONCLUSIONS: The course was beneficial for participants with mild or severe depression, and treatment acceptability was high. It should be fitted into a stepped-care protocol that varies intervention intensity according to clinical needs, using the post-treatment level of functioning as an indication for the next step.

Author information

Author/s: Haringsma, R (R); Engels, G I (GI); Cuijpers, P (P); Spinhoven, P (P);

Affiliation: Division of Clinical and Health Psychology, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands. haringsma(-atsign-)fsw.leidenuniv.nl

Journal and publication information

Publication Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: International psychogeriatrics / IPA (Int Psychogeriatr), published in United States. (Language: eng)

Reference: 2006-Jun; vol 18 (issue 2) : pp 307-25

Dates: Created 2006/05/31; Completed 2006/11/14; Revised 2007/11/15;

PMID: 16255838, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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