title: Prevention of major depression in complex medically ill patients: preliminary results from a randomized, controlled trial.
abstract: BACKGROUND
  Depression is highly prevalent in patients with physical illness and is associated with a diminished quality of life and poorer medical outcomes.
  
  
  OBJECTIVE
  The authors evaluated whether a multifaceted intervention conducted by a psychiatric consultation-liaison nurse could reduce the incidence of major depression in rheumatology inpatients and diabetes outpatients with a high level of case complexity.
  
  
  METHODS
  Of 247 randomized patients, the authors identified 100 patients with a high level of case complexity at baseline and without major depression (65 rheumatology and 35 diabetes patients). Patients were randomized to usual care (N=53) or to a nurse-led intervention (N=47). Main outcomes were the incidence of major depression and severity of depressive symptoms during a 1-year follow-up, based on quarterly assessments with standardized psychiatric interviews.
  
  
  RESULTS
  The incidence of major depression was 63% in usual-care patients and 36% in the intervention group. Effects of intervention on depressive symptoms were observed in outpatients with diabetes but not in rheumatology inpatients.
  
  
  CONCLUSIONS
  These preliminary results based on subgroup analysis suggest that a multifaceted nurse-led intervention may prevent the occurrence of major depression in complex medically ill patients and reduce depressive symptoms in diabetes outpatients.
authors: Dept. of Psychiatry; University of Groningen, P.O. Box 30.001; 9700 RB Groningen, The Netherlands. peter.de.jonge@med.umcg.nl
authors: Peter
authors: P
authors: de Jonge
authors: Fatima Bel
authors: FB
authors: Hadj
authors: Daria
authors: D
authors: Boffa
authors: Catherine
authors: C
authors: Zdrojewski
authors: Yves
authors: Y
authors: Dorogi
authors: Alexander
authors: A
authors: So
authors: Juan
authors: J
authors: Ruiz
authors: Friedrich
authors: F
authors: Stiefel
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000523:psychology*; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000451:nursing / Q000517:prevention & control* / Q000523:psychology; D003920:Diabetes Mellitus / Q000523:psychology*; D005260:Female; D005356:Fibromyalgia / Q000523:psychology*; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology; D010348:Patient Care Team; D010349:Patient Compliance / Q000523:psychology; D011568:Psychiatric Nursing; D011613:Psychotherapy; D012017:Referral and Consultation; D012216:Rheumatic Diseases / Q000523:psychology*; D012803:Sick Role; D016896:Treatment Outcome