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[Prevention of depression and anxiety in older people]
P J van 't Veer-Tazelaar1, P Cuijpers, A J Beekman
1Institute of Health and Care Research, VU Medisch Centrum, Amsterdam. n.vantveer@ggzingeest.nl
Background:
In older people, sub-threshold symptom levels of depression or anxiety are characterised by a high prevalence and an unfavourable prognosis. They are the best predictors of the onset of full-blown disorders. There is an urgent need to develop effective preventative strategies.
Aim:
To determine the effectiveness and feasibility of an indicated depression- and anxiety- prevention programme for older people.
Methods:
170 individuals (75+) with sub-threshold symptom levels of depression or anxiety were randomized between a preventive intervention programme consisting of watchful waiting, bibliotherapy, problem-solving treatment, and re-referral to primary care to discuss medication, or usual care.
Results:
The intervention halved the incidence of (DSM-IV) depressive and anxiety disorders.
Conclusion:
A stepped-care approach to the prevention of depression and anxiety in later life was successful in halving the incidence of depressive and anxiety disorders after one year, were cost-effective, and the favourable effects were sustained for up to 24 months.
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