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首页> 外文期刊>BMC Psychiatry >Behavioural activation by mental health nurses for late-life depression in primary care: a randomized controlled trial
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Behavioural activation by mental health nurses for late-life depression in primary care: a randomized controlled trial

机译：心理保健护士对初级保健中晚期抑郁症的行为激活：一项随机对照试验

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Background Depressive symptoms are common in older adults. The effectiveness of pharmacological treatments and the availability of psychological treatments in primary care are limited. A behavioural approach to depression treatment might be beneficial to many older adults but such care is still largely unavailable. Behavioural Activation (BA) protocols are less complicated and more easy to train than other psychological therapies, making them very suitable for delivery by less specialised therapists. The recent introduction of the mental health nurse in primary care centres in the Netherlands has created major opportunities for improving the accessibility of psychological treatments for late-life depression in primary care. BA may thus address the needs of older patients while improving treatment outcome and lowering costs.The primary objective of this study is to compare the effectiveness and cost-effectiveness of BA in comparison with treatment as usual (TAU) for late-life depression in Dutch primary care. A secondary goal is to explore several potential mechanisms of change, as well as predictors and moderators of treatment outcome of BA for late-life depression. Methods/design Cluster-randomised controlled multicentre trial with two parallel groups: a) behavioural activation, and b) treatment as usual, conducted in primary care centres with a follow-up of 52?weeks. The main inclusion criterion is a PHQ-9 score?>?9. Patients are excluded from the trial in case of severe mental illness that requires specialized treatment, high suicide risk, drug and/or alcohol abuse, prior psychotherapy, change in dosage or type of prescribed antidepressants in the previous 12?weeks, or moderate to severe cognitive impairment. The intervention consists of 8 weekly 30-min BA sessions delivered by a trained mental health nurse. Discussion We expect BA to be an effective and cost-effective treatment for late-life depression compared to TAU. BA delivered by mental health nurses could increase the availability and accessibility of non-pharmacological treatments for late-life depression in primary care. Trial registration This study is retrospectively registered in the Dutch Clinical Trial Register NTR6013 on August 25th 2016.
机译：背景技术抑郁症状在老年人中很常见。初级保健中药理治疗的有效性和心理治疗的可用性受到限制。行为疗法对抑郁症的治疗可能对许多老年人都是有益的，但这种护理仍然非常缺乏。行为激活（BA）协议比其他心理治疗方法更简单，更容易训练，使其非常适合不那么专业的治疗师进行交付。最近在荷兰的初级保健中心引进了心理保健护士，这为改善初级保健后期抑郁症的心理治疗方法提供了重要的机会。因此，BA可以满足老年患者的需求，同时改善治疗效果并降低成本。这项研究的主要目的是比较BA与常规治疗（TAU）对荷兰晚期抑郁症的有效性和成本效益。初级卫生保健。次要目标是探索几种可能的改变机制，以及晚期抑郁症BA治疗结果的预测因素和调节因素。方法/设计两组平行的多中心随机对照多中心试验：a）行为激活，b）照常治疗，在初级保健中心进行，随访52周。主要纳入标准为PHQ-9得分≥9。如果严重精神疾病需要特殊治疗，极高的自杀风险，药物和/或酒精滥用，先前的心理治疗，过去12周内处方抗抑郁药的剂量或类型改变或中度至重度，则将患者排除在试验之外认知障碍。干预措施包括由训练有素的精神保健护士进行的每周8次30分钟BA课程。讨论我们希望与TAU相比，BA是一种治疗晚期抑郁症的有效且具有成本效益的方法。精神卫生护士提供的BA可以增加非药物治疗对初级保健中晚期抑郁症的可用性和可及性。试验注册该研究回顾性注册于2016年8月25日在荷兰临床试验注册NTR6013中。

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