TY - JOUR T1 - A stepped-care prevention programme decreased depression and anxiety disorders in elderly patients JF - Evidence Based Medicine JO - Evid Based Med SP - 146 LP - 146 DO - 10.1136/ebm.14.5.146 VL - 14 IS - 5 A2 - , Y1 - 2009/10/01 UR - http://ebm.bmj.com/content/14/5/146.abstract N2 - Design: randomised controlled trial. ISRCTN26474556. Allocation: {concealed}*.† Blinding: blinded (outcome assessors).* 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 … ER -