Recruiting participants for interventions to prevent the onset of depressive disorders: possible ways to increase participation rates

Pim Cuijpers, Annemieke van Straten, Lisanne Warmerdam, Marie José van Rooy, Pim Cuijpers, Annemieke van Straten, Lisanne Warmerdam, Marie José van Rooy

Abstract

Background: Although indicated prevention of depression is available for about 80% of the Dutch population at little or no cost, only a small proportion of those with subthreshold depression make use of these services.

Methods: A narrative review is conducted of the Dutch preventive services in mental health care, also addressing the problem of low participation rates. We describe possible causes of these low participation rates, which may be related to the participants themselves, the service system, and the communication to the public, and we put forward possible solutions to this problem.

Results: There are three main groups of reasons why the participation rates are low: reasons within the participants (e.g., not considering themselves as being at risk; thinking the interventions are not effective; or being unwilling to participate because of the stigma associated with depression); reasons within the health care system; and reasons associated with the communication about the preventive services. Possible solutions to increasing the participation rate include organizing mass media campaigns, developing internet-based preventive interventions, adapting preventive interventions to the needs of specific subpopulations, positioning the services in primary care, integrating the interventions in community-wide interventions, and systematically screening high-risk groups for potential participants.

Discussion: Prevention could play an important role in public mental health in reducing the enormous burden of depression. However, before this can be realized more research is needed to explore why participation rates are low and how these rates can be improved.

References

    1. Cuijpers P, van Straten A, Smit F, Mihalopoulos C, Beekman A. Preventing the onset of depressive disorders: A meta-analytic review of psychological interventions. Am J Psychiatry. 2008;165:1272–80. doi: 10.1176/appi.ajp.2008.07091422.
    1. Cuijpers P, Muñoz RF, Clarke GN, Lewinsohn PM. Psychoeducational treatment and prevention of depression: The "Coping with Depression" course thirty years later. Clinical Psychology Review. 2009;29:449–458. doi: 10.1016/j.cpr.2009.04.005.
    1. Ruiter M, Jonge de M. Aard- en omvangstudie GGZ- en verslavingspreventie 2007. 2008. Trimbos-instituut, [Capacity and use of preventive services in mental health care and addiction services]
    1. Cuijpers P, De Graaf R, Van Dorsselaer S. Minor depression: risk profiles, functional disability, health care use and risk of developing major depression. J Affect Dis. 2004;79:71–9. doi: 10.1016/S0165-0327(02)00348-8.
    1. Mrazek PJ, Haggerty RJ. Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research. Washington, DC, National Academies Press; 1994.
    1. Haringsma R, Engels GI, Cuijpers P, Spinhoven P. Effectiveness of the Coping With Depression (CWD) course for older adults provided by the community-based mental health care system in the Netherlands: a randomized controlled field trial. Int Psychogeriatr. 2006;18:307–325. doi: 10.1017/S104161020500253X.
    1. Bijl RV, Ravelli A. Psychiatric morbidity, service use, and need for care in the general population: results of The Netherlands Mental Health Survey and Incidence Study. Am J Public Health. 2000;90:602–607. doi: 10.2105/AJPH.90.4.602.
    1. Van Beljouw IMJ, Verhaak PFM, Prins MA, Cuijpers P, Penninx BWJH, Bensing JM. Receiving no treatment for common mental disorders: reasons and determinants. Psychiatr Serv. 2010;61:250–257. doi: 10.1176/appi.ps.61.3.250.
    1. Schomerus G, Angermeyer MC, Matschinger H, Riedel-Heller SG. Public attitudes towards prevention of depression. J Affect Dis. 2008;106:257–263. doi: 10.1016/j.jad.2007.06.013.
    1. Parslow RA, Jorm AF. Improving Australians' depression literacy. Medical Journal of Australia. 2002;177:S117–S121.
    1. Crisp AH, Gelder MG, Rix S, Meltzer HI, Rowlands OJ. Stigmatization of people with mental illness. Br J Psychiatry. 2000;177:4–7. doi: 10.1192/bjp.177.1.4.
    1. Crisp A, Gelder M, Goddard E, Meltzer H. Stigmatization of people with mental illness: a follow-up study within the Changing Minds campaign of the Royal College of Psychiatrists. World Psychiatry. 2005;4:2.
    1. O'Hara MW, Gorman LL, Wright EJ. Description and evaluation of the Iowa Depression awareness, recognition and treatment programme. Am J Psychiatry. 1996;153:645–9.
    1. Greenfield SF, Meszler Reizes J, Magruder KM, Muenz LR, Kopans B, Jacobs DG. Effectiveness of community-based screening for depression. Am J Psychiatry. 1997;154:1391–7.
    1. Greenfield SF, Meszler Reizes J, Magruder KM, Muenz LR, Kopans B, Kozloff RC, Jacobs DG. Treatment for depression following the 1996 National Depression Screening Day. Am J Psychiatry. 2000;157:1867–9. doi: 10.1176/appi.ajp.157.11.1867.
    1. Hickie I. Can we reduce the burden of depression? The Australian experience with beyondblue: The national depression initiative. Australas Psychiatry. 2004. pp. S38–46.
    1. Jorm AF, Christensen H, Griffiths KM. Changes in depression awareness and attitudes in Australia: the impact of beyondblue: The national depression initiative. Aust N Z J Psychiatry. 2006;40:42–46.
    1. Hegerl U, Althaus D, Schmidtke A, Niklewski G. The alliance against depression: 2-year evaluation of a community-based intervention to reduce suicidality. Psychol Med. 2006;36:1225–33. doi: 10.1017/S003329170600780X.
    1. Hegerl U, Wittenburg L. European Alliance Against Depression Consortium. Focus on mental health care reforms in Europe: the European alliance against depression: a multilevel approach to the prevention of suicidal behavior. Psychiatr Serv. 2009;60:596–9. doi: 10.1176/appi.ps.60.5.596.
    1. Spek V, Cuijpers P, Nyklíček I, Riper H, Keyzer J, Pop V. Internet-based cognitive behavior therapy for mood and anxiety disorders: a meta-analysis. Psychol Med. 2007;37:319–28. doi: 10.1017/S0033291706008944. (2007)
    1. Warmerdam L, van Straten A, Twisk J, Cuijpers P. Internet-based treatment for adults with depressive symptoms: a randomized controlled trial. J Med Intern Res. 2008;10:e44. doi: 10.2196/jmir.1094.
    1. Marks IM, Cavanagh K, Gega L. Maudsley Monographs No. 45. Hands-on Help: Computer-aided psychotherapy. Psychology Press, Hove, UK; 2007.
    1. Seligman MEP, Schulman P, DeRubeis RJ, Hollon SD. The prevention of depression and anxiety. Prevention & Treatment. 1999;2 np.
    1. Muñoz RF, Ying YW, Bernal G, Perez-Stable EJ, Sorensen JL, Hargreaves WA, Miranda J, Miller LS. Prevention of depression with primary care patients: a randomized controlled trial. Am J Community Psychol. 1995;23:199–222. doi: 10.1007/BF02506936.
    1. Willemse GRWM, Smit F, Cuijpers P, Tiemens BG. Minimal contact psychotherapy for sub-threshold depression in primary care: a randomised trial. Br J Psychiatry. 2004;185:416–21. doi: 10.1192/bjp.185.5.416.
    1. Van 't Veer-Tazelaar PA, van Marwijk HWJ, van Oppen P, van Hout HPJ, van der Horst HE, Cuijpers P, Smit F, Beekman ATF. Stepped-care prevention of anxiety and depression in late life: a randomized controlled trial. Arch Gen Psychiatry. 2009;66:297–304. doi: 10.1001/archgenpsychiatry.2008.555.
    1. Holder HD, Gruenewald PJ, Ponicki WR, Treno AJ, Grube JW, Saltz RF, Voas RB, Reynolds R, Davis J, Sanchez L, Gaumont G, Roeper P. Effect of community based interventions on high-risk drinking and alcohol-related injuries. JAMA. 2000;284:2341–7. doi: 10.1001/jama.284.18.2341.
    1. Wagenaar AC, Murray DM, Gehan JP. Communities mobilizing for change on alcohol (CMCA): effects of a randomized trial on arrests and traffic accidents. Addiction. 2000;95:209–17. doi: 10.1046/j.1360-0443.2000.9522097.x.
    1. Sowden A, Arblaster L, Stead L. Community interventions for preventing smoking in young people. Cochrane Database Syst Rev. 2003;1:CD001291.
    1. Hawkins JD, Brown EC, Oesterle S, Arthur MW, Abbott RD, Catalano RF. Early effects of Communities That Care on targeted risks and initiation of delinquent behavior and substance use. J Adolesc Health. 2008;43:15–22. doi: 10.1016/j.jadohealth.2008.01.022.
    1. Clarke GN, Hawkins W, Murphy M, Sheeber LB, Lewinsohn PM, Seeley JR. Targeted prevention of unipolar depressive disorder in an at-risk sample of high school adolescents: a randomized trial of a group cognitive intervention. J Am Acad Child Adolesc Psychiatry. 1995;34:312–21. doi: 10.1097/00004583-199503000-00016.
    1. Arnarson EO, Craighead WE. Prevention of depression among Icelandic adolescents. Behav Res Ther. 2009;47:577–85. doi: 10.1016/j.brat.2009.03.011.
    1. Brugha TS, Wheatley S, Taub NA, Culverwell A, Friedman T, Kirwan P, Jones DR, Shapiro DA. Pragmatic randomized trial of antenatal intervention to prevent post-natal depression by reducing psychosocial risk factors. Psychol Med. 2000;30:1273–1281. doi: 10.1017/S0033291799002937.
    1. Muñoz RF, Le HN, Ippen CG, Diaz MA, Urizar GG Jr, Soto J, Mendelson T, Delucchi K, Lieberman AF. Prevention of postpartum depression in low-income women: development of the Mamás y Bebés/Mothers and Babies Course. Cogn Behav Pract. 2007;14:70–83. doi: 10.1016/j.cbpra.2006.04.021.
    1. Zlotnick C, Miller IW, Pearlstein T, Howard M, Sweeney P. A preventive intervention for pregnant women on public assistance at risk for postpartum depression. Am J Psychiatry. 2006;163:1443–1445. doi: 10.1176/appi.ajp.163.8.1443.
    1. Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model. Health Educ Q. 1988;15:175–83.
    1. Ajzen I. The theory of planned behavior. Organiz Behav Hum Dec Proc. 1991;50:179–211. doi: 10.1016/0749-5978(91)90020-T.
    1. Rosenstock IM. Why people use health services. Milbank Mem Fund Q. 1966;44:94–127. doi: 10.2307/3348967.

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever