Extrait

Background and study aims Depression accounts for the highest burden of disease of any mental disorder. Most patients with depression seek healthcare through their GP surgeries. The WHO recommends the use of psychoeducation for mild depression and antidepressant drugs or psychological treatments (PT) for moderate to severe depression. Antidepressants are useful only for a third to half of patients with depression. People do not adhere to this treatment, it has high relapse rates, and is not routinely available in GP surgeries. A major hurdle to the implementation of PT in GP practices of developing countries is the lack of skilled human resources. The aim of this study is to find out the effectiveness and cost-effectiveness of the Healthy Activity Program (HAP). Who can participate? Adults with moderate/severe depression can participate in this study. What does the study involve? Participants with moderate to severe depression will be identified by screening. Eligible participants will be randomly allocated to receive either enhanced usual care (EUC) or EUC plus HAP. The EUC will comprise providing PHC doctors with the contextualised WHO guidelines and the results of the patient health questionnaire. Participants in the HAP group will receive, in addition to EUC, an eight-session PT delivered by trained and supervised lay counsellors, over a maximum period of 3 months. This PT has been systematically developed based on evidence and includes psychoeducation, problem-solving, behavioural activation (BA) and relaxation training. What are the possible benefits and risks of participating? Participants will receive the counselling sessions from a trained counsellor along with doctor’s treatment at no extra cost. If our study finds that adding counselling makes treatment more effective, this will help us work with the government to make counselling available in clinics across Goa and India. We do not expect any risks from taking part, apart from the fact that patients may find discussing their health and personal problems to be distressing. In our experience, most people do not experience such feelings. Patients are however assured that our counsellors and researchers have been trained to handle such situations and if required, services of other health experts will be made available. Where is the study run from? The study will be conducted in eight primary health centres (PHCs) in the North district of Goa, India When is study starting and how long is it expected to run for? October 2013 to October 2015 Who is funding the study? The Wellcome Trust (UK) Who is the main contact? Prof. Vikram Patel +91 (0)9822132038 [email protected]

Critère d'inclusion

• General Adult Depression

Liens

• ictrp
• isrctn