Transcript Studenten Depressie Onderzoek

Towards a better
understanding of the
psychological processes which
lead to the incidence of
depressive disoders: a
prospective study
Schedule
• Theoretical and practical framework
• Research design
• Discussion, remarks and questions
Prevalence of mood disorders (%)
Men
Women
Total
Last
year
Ever
Last
year
Ever
Last
year
Ever
Mood disorders
5,7
13,6
9,7
24,5
7.6
19,0
•Depressive disorder
4,1
10,9
7,5
20,1
5,8
15,4
•Dysthymic disorder
1,4
3,8
3,2
8,9
2,3
6,3
•Bipolar disorder
1,1
1,5
1,1
2,1
1,1
1,8
•Minor depression
7,5
Andrews et al. (2004)
• Current situation in treatment mood disorder:
– Coverage: 60%.
– Effective coverage: 34%
– Result: 15% YLD averted
• Possible maximum with evidence based
treatment
– Coverage: 100%
– Effective coverage: 100%
– Result: 35% YLD averted
Prevention
• Prevention to reduce the burden of
disease
• Universal prevention seems to have little
effect
• Conclusion: selective prevention!
– Selecting: who and when?
– There’s a gap in emperical knowledge of
processes which lead to the incidence of
depression
Alloy at al. (1999 & 2006)
• Prospective study
• Diagnostic interview
• High Risk approach
• But:
– Just cognitive model
– Participants with lifetime depressive disorder
in study
Research design
•
•
•
•
•
Testing different theoretical models
High Risk approach
Diagnostic interview
First-ever incidence
Prospective (longitudinal) study
Theoretical models: crietria
• De model should be clearly described in
the existing literature.
• There is (some) emperical support for the
model.
• It is possible to operationalize the key
elements of the model.
• Preferably, there’s an association between
the model and an intervention for
depression.
Theoretical models
• Learned helplessness-theory (Abramson
et al., 1978)
• Cognitive theory (Beck, 1967 & 1976)
• Theory of the ruminating response style
(Nolen-Hoeksema, 1993 & 2000)
• Attachment theory (Bowlby, 1969 & 1988)
• Behavioral theory (Lewinsohn, 1985)
• Interpersonal theory (Joiner, 2002)
High Risk approach
• Large group of first-year students is invited
to fill out an online questionnaire
• High Risk-group is selected for
participation in the study
• Low Risk-group is selected as a
controlgroup
High Risk approach
Measured concepts (risk):
–
–
–
–
–
–
Self Esteem (RSES; Rosenberg, 1965)
Mastery (Mastery Scale; Pearlin & Schooler, 1978)
Automatic Thoughts (ATQ; Hollon & Kendall, 1990)
Worrying (PSWQ; Meyer et al., 1990)
Attachment Style (AAS; Collins & Read, 1990)
Childhood trauma and parental psychopathology
(Subscale of NEMESIS questionnaire; Bijl et al.,
1998)
High Risk approach
• Measured concepts (other)
– Depressive symptoms (CES-D; Ensel, 1986)
– Anxiety symptoms (HADS; Zigmond & Snaith,
1983)
– Neuroticism (NEO-FFI; Costa & McRea,
1992)
– Demografic characteristics
High Risk approach
• Every concept is measured by a
questionnaire
• Of every ‘risk’questionnaire the 10%
participants scoring highest is selected
(HR-group, ±50% of respondents)
• Participants scoring among the 60%
lowest scores of every questionnaire are
selected (LR-group, ±15% of respondents)
Diagnostic interview
• Depressive and anxiety disorders are
measured with the CIDI-interview (WHO,
1997)
• Interview at baseline
Incidence
Only first-ever cases are included.
Participants without a current or lifetime
diagnoses of depression are included in
the study
Research design:
prospective study
Participants will be followed for 2 years
• Every 6 months a measurement (total of
5):
– At baseline, after 1 and 2 years participants fill
out a questionnaire and are interviewed
– In between, participants fill out a
questionnaire every 6 months
Preliminary results
• 481 of the 2815 invited students filled out the
questionnaire
• Of 481 participants ±50% are in the HR-group
and ±15% in the LR-group
• 214 partcipants were interviewed
• 152 of the interviewed participants did not have
a depressive disorder (current or lifetime)
• 115 participants are included in the study up ‘till
now
Preliminary results
• At this moment, we’re still including
participants (participants are filling out
questionnaires and are being interviewed)
• We hope to include 300 participants and
follow them for 2 years
• First follow-up measurement: end of april
Discussion
Questions or remarks?