title: Depression and anxiety, an indicated prevention (DIP) protocol in homes for the elderly: feasibility and (cost) effectiveness of a stepped care programme.
abstract: BACKGROUND
  Depressive and anxiety disorders are a very common, serious and underdetected problem in homes for the elderly. Elderly persons in residential homes are at high risk for developing major depressive and anxiety disorders, and, therefore, deserve attention with regard to prevention.
  
  
  METHODS
  This protocol describes a randomised trial on the feasibility and (cost) effectiveness of a stepped-care programme for prevention of depressive and anxiety disorders in homes for the elderly. The main outcome measure is the incidence of depressive and anxiety disorder in one year with a two years follow up. Secondary outcomes are symptoms of depression and anxiety, quality of life, direct health care costs and satisfaction with treatment.
  
  
  CONCLUSIONS
  The number of studies examining the effects of preventive interventions on the incidence of mental disorders in the elderly population is very small. However, indicated prevention by means of a stepped-care programme seems to be an important option for decreasing the burden of illness for residents and their caregivers. This study contributes to the body of knowledge in this field. Positive effects may contribute to further use and development of tailored, (cost-) effective and easy to use interventions in a preventive stepped-care programme.
authors.affiliation: Department of General Practice, VU University Medical Centre, Amsterdam, The Netherlands. els.dozeman@vumc.nl.
authors.forename: Els
authors.initials: E
authors.lastname: Dozeman
authors.forename: Digna J F
authors.initials: DJ
authors.lastname: van Schaik
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
authors.forename: Wim A B
authors.initials: WA
authors.lastname: Stalman
authors.forename: Judith E
authors.initials: JE
authors.lastname: Bosmans
authors.forename: Harm W J
authors.initials: HW
authors.lastname: van Marwijk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000191:economics* / Q000517:prevention & control* / Q000523:psychology; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D003866:Depressive Disorder / Q000191:economics* / Q000517:prevention & control* / Q000523:psychology; D005240:Feasibility Studies; D006707:Homes for the Aged / Q000191:economics*; D006801:Humans