title: [Prevention of depression and anxiety in older people].
abstract: BACKGROUND
  In older people, sub-threshold symptom levels of depression or anxiety are characterised by a high prevalence and an unfavourable prognosis. They are the best predictors of the onset of full-blown disorders. There is an urgent need to develop effective preventative strategies.
  
  
  OBJECTIVE
  To determine the effectiveness and feasibility of an indicated depression- and anxiety- prevention programme for older people.
  
  
  METHODS
  170 individuals (75+) with sub-threshold symptom levels of depression or anxiety were randomized between a preventive intervention programme consisting of watchful waiting, bibliotherapy, problem-solving treatment, and re-referral to primary care to discuss medication, or usual care.
  
  
  RESULTS
  The intervention halved the incidence of (DSM-IV) depressive and anxiety disorders.
  
  
  CONCLUSIONS
  A stepped-care approach to the prevention of depression and anxiety in later life was successful in halving the incidence of depressive and anxiety disorders after one year, were cost-effective, and the favourable effects were sustained for up to 24 months.
authors: Institute of Health and Care Research, VU Medisch Centrum, Amsterdam. n.vantveer@ggzingeest.nl
authors: P J
authors: PJ
authors: van 't Veer-Tazelaar
authors: P
authors: P
authors: Cuijpers
authors: A J
authors: AJ
authors: Beekman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001007:Anxiety / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003863:Depression / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011320:Primary Health Care; D015397:Program Evaluation; D057832:Watchful Waiting