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A stepped-care prevention programme decreased depression and anxiety disorders in elderly patients

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Study design

Design:

randomised controlled trial. ISRCTN26474556.

Allocation:

{concealed}*.†

Blinding:

blinded (outcome assessors).*

Study question

Setting:

primary care practices in the northwestern Netherlands.

Patients:

170 general practice patients ⩾75 years of age (mean age 81 y, 74% women) who had Center for Epidemiologic Studies Depression Scale (CES-D) scores ⩾16 and did not meet DSM-IV criteria for depressive or anxiety disorder in the previous 12 months as measured by the Mini International Neuropsychiatric Interview (MINI). Patients with serious cognitive decline were excluded. All patients completed 3 months of watchful waiting, after which they completed a second CES-D questionnaire. Patients with scores ⩾16 underwent a diagnostic MINI. Patients with CES-D scores ⩾16 but who did not have a depressive or anxiety disorder were randomized.

Intervention:

stepped care (n = 86) or usual care (n = 84). Stepped-care patients progressed from watchful waiting through up to …

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