Preventing depression in the community by voluntary sector providers

PERSUADE

The number of people with depression is increasing globally; depression is set to become the leading cause of disability worldwide by 2030. Treatments for depression have limited usefulness and have only led to a 35% reduction of cases of depression, as compared to those receiving no treatment. People with untreated depression symptoms are at an increased risk of persistent depression with poor outcomes. We need to develop treatments that can be delivered at the very early stage of the illness thus preventing progression into full blown symptoms of depression.

One of the major risk factors for depression is sub-threshold depression. Sub-threshold depression is a condition where the person has developed some of the symptoms of stress and low mood but the number of symptom, and their severity, is lower than the threshold that we would use to diagnose someone with depression. In routine clinical practice we use a score of 10 or above on a depression questionnaire (Personal Health Questionnaire PHQ 9) to diagnose depression. For this study we will use the score of between 5 and 9 on the PHQ 9 to indicate sub threshold depression.

Our clinical experience tells us that it can be difficult to engage people with mild depression into preventive treatments that may require ongoing commitment. So, we plan to use user involvement to adapt and evaluate a acceptable psychological therapy program which is acceptable. It will be based on Cognitive Behaviour Therapy (CBT) principles. To increase engagement and attendance the intervention will be delivered by trained voluntary sector staff in a community setting. It will be a 1 day (8 hour) session, delivered on the weekend to improve engagement and attendance.  We will recruit up to 64 participants to this feasibility study as a first step towards designing future trials.

Amount awarded: £77,285