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Sponsors and Collaborators: |
National University Hospital, Singapore National University, Singapore |
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Information provided by: | National University Hospital, Singapore |
ClinicalTrials.gov Identifier: | NCT00430404 |
To evaluate the effectiveness of a community-based strategy of routine population mass screening for depression with follow-up feedback and management in a primary care non-psychiatric setting involving a structured, multifaceted, collaborative (primary care and hospital-based)shared care programme.
Hypotheses:
We hypothesize that a community-based early psychiatric interventional strategy (CEPIS) for depression in the elderly leads to increased recognition of depression by primary care physicians, more initiation of treatment for emotional problems, and improved outcomes for patients with depression, as measured by:
Condition | Intervention | Phase |
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Depression |
Procedure: Structured shared care with treatment protocol & support |
Phase IV |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Double-Blind, Active Control, Parallel Assignment |
Official Title: | Randomized Controlled Trial of a Community-Based Early Psychiatric Intervention Strategy to Screen and Manage Depression in the Elderly |
Estimated Enrollment: | 240 |
Study Start Date: | August 2004 |
Estimated Study Completion Date: | September 2007 |
Depression is a highly prevalent, clinically under-recognized and under-treated medical disorder world wide. In Singapore, 17% of the adult population experience recent psychiatric disturbances, yet only 6% use the services of any health professional. General practitioners are the most commonly preferred caregiver, and actually used by 41.1% of those who sought help. At the same time, suicide rates especially among the elderly remain at very high levels compared to other countries in the world. In recent decades, screening questionnaires have been developed and validated that are suitable for the initial detection of depression in the primary care setting. Previous research have shown that screening for depression do not result in increased recognition rates of mental disorders unless positive cases are selectively fed back to primary care physicians. They also do not translate into increased rates of interventional activities such as initiation of therapy and referral to mental health specialists. Neither dose primary care physician education or clinical practice guidelines result in any improved outcomes for the patients unless these are accompanied by more sophisticated strategies in the organization and delivery of care, such as structured, collaborative, multidisciplinary care together with quality improvement processes.
More empirical data are therefore needed to establish whether screening for psychiatric disorders will enhance the recognition of clinical disorder, leading to better patient outcomes.
Ages Eligible for Study: | 60 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Singapore | |
Department of Psychological Medicine, National University Hospital, 5 Lower Kent Ridge Road | |
Singapore, Singapore, 119074 |
Principal Investigator: | Ng Tz Pin, MD,MFPHM | Gerontological Research Programme, Faculty of Medicine, National University of Singapore |
Responsible Party: | National University Hospital, Singapore ( Ng Tz Pin, MD, MFPHM ) |
Study ID Numbers: | NMRC/0846/2004 |
Study First Received: | January 31, 2007 |
Last Updated: | May 13, 2008 |
ClinicalTrials.gov Identifier: | NCT00430404 History of Changes |
Health Authority: | United States: Institutional Review Board |
Depression Mental Disorders Mood Disorders Depressive Disorder Behavioral Symptoms |
Depression Mental Disorders Mood Disorders Depressive Disorder Behavioral Symptoms |