title: Depression in Visual Impairment Trial (DEPVIT): A Randomized Clinical Trial of Depression Treatments in People With Low Vision.
abstract: OBJECTIVE
  The purpose of this study was to compare two interventions for depression, problem solving treatment (PST) and referral to the patient's physician, with a waiting-list control group in people with sight loss and depressive symptoms.
  
  
  METHODS
  This was an assessor-masked, exploratory, multicenter, randomized clinical trial, with concurrent economic analysis. Of 1008 consecutive attendees at 14 low-vision rehabilitation centers in Britain, 43% (n = 430) screened positive for depressive symptoms on the Geriatric Depression Scale and 85 of these attendees participated in the trial. Eligible participants were randomized in the ratio 1:1:1 to PST, referral to their physician, or a waiting-list control arm. PST is a manualized talking intervention delivered by a trained therapist who teaches people over six to eight sessions to implement a seven-step method for solving their problems. Referral to the physician involved sending a referral letter to the person's physician, encouraging him or her to consider treatment according to the stepped care protocol recommended by the U.K.'s National Institute of Health and Care Excellence. The primary outcome was change in depressive symptoms (6 months after baseline) as determined by the Beck Depression Inventory.
  
  
  RESULTS
  At 6 months, Beck Depression Inventory scores reduced by 1.05 (SD 8.85), 2.11 (SD 7.60), and 2.68 (SD 7.93) in the waiting-list control, referral, and PST arms, respectively. The cost per patient of the PST intervention was £1176 in Wales and £1296 in London.
  
  
  CONCLUSIONS
  Depressive symptoms improved most in the PST group and least in the control group. However, the change was small and the uncertainty of the measurements relatively large.
authors.affiliation: School of Optometry and Vision Sciences Cardiff University, Cardiff, United Kingdom.
authors.forename: Claire L
authors.initials: CL
authors.lastname: Nollett
authors.affiliation: Centre for Health Economics and Medicines Evaluation, School of Healthcare Sciences, College of Health and Behavioural Sciences, Bangor University, Gwynedd, United Kingdom.
authors.forename: Nathan
authors.initials: N
authors.lastname: Bray
authors.affiliation: National Institute for Health Research Biomedical Research Center (NIHR BRC) for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: Catey
authors.initials: C
authors.lastname: Bunce
authors.affiliation: Department of Psychiatry and Human Behaviour, Sidney Kimmel Medical College at Thomas Jefferson University, Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, United States.
authors.forename: Robin J
authors.initials: RJ
authors.lastname: Casten
authors.affiliation: Centre for Health Economics and Medicines Evaluation, School of Healthcare Sciences, College of Health and Behavioural Sciences, Bangor University, Gwynedd, United Kingdom.
authors.forename: Rhiannon T
authors.initials: RT
authors.lastname: Edwards
authors.affiliation: Department of Psychiatry, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, United States.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Hegel
authors.affiliation: Ophthalmology (Eye) Department South Wing, St. Thomas' Hospital, London, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Janikoun
authors.affiliation: National Institute for Social Care and Health Research Clinical Research Centre (NISCHR CRC) South East Wales Research Network/Rhwydwaith Ymchwil De Ddwyrain Cymru, Cardiff, United Kingdom.
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Jumbe
authors.affiliation: School of Optometry and Vision Sciences Cardiff University, Cardiff, United Kingdom.
authors.forename: Barbara
authors.initials: B
authors.lastname: Ryan
authors.affiliation: University of South Wales, Pontipridd, Wales, United Kingdom.
authors.forename: Julia
authors.initials: J
authors.lastname: Shearn
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, United Kingdom.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Smith
authors.affiliation: Ophthalmology (Eye) Department South Wing, St. Thomas' Hospital, London, United Kingdom.
authors.forename: Miles
authors.initials: M
authors.lastname: Stanford
authors.affiliation: National Institute for Health Research Biomedical Research Center (NIHR BRC) for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: Wen
authors.initials: W
authors.lastname: Xing
authors.affiliation: School of Optometry and Vision Sciences Cardiff University, Cardiff, United Kingdom.
authors.forename: Tom H
authors.initials: TH
authors.lastname: Margrain
mesh_terms: D000368:Aged; D001521:Behavior Therapy / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D003863:Depression / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008131:London; D008297:Male; D011340:Problem Solving / Q000502:physiology*; D011569:Psychiatric Status Rating Scales; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D015354:Vision, Low / Q000150:complications* / Q000628:therapy